Public private strategy for elimination of congenital transmission of infectious diseases - Argentina

Abstract

Problem Mother-to-child transmission of HIV, Syphilis, Chagas and Hepatitis B constitutes a significant public health issue in Latin America, mostly because of the great morbidity and mortality of these diseases, the social impact of their consequences and the opportunity to eliminate the transmission with timely diagnosis and treatment. Useful strategies to face this mayor problem may be beneficial for the region. Description of the Problem The number of newborns with congenital syphilis has been growing all over the region. Moreover, Argentina is the country with the largest affected population with Chagas Disease and, although treatment is very effective during infancy, less than 1% of the infected population accesses the drug. The recurring economic crisis raised the percentage of poverty from 4.6 % in 1974 up to 35.4 % in 2019, thus worsening health determinants and adding new challenges to the healthcare sector. The Framework for Elimination of Mother-to-Child Transmission of HIV, Syphilis, Hepatitis B and Chagas (EMTCT Plus) proposed by the Pan American Health Organization in 2017 was approved by Argentina and is of low complexity. Under this context, the non-governmental organization Mundo Sano Foundation together with the Municipality of Almirante Brown elaborated an intervention model to implement EMTCT Plus in a municipality of Buenos Aires Province. Results After two years, 3561 pregnant women were evaluated as well as their babies: 317 were positive for syphilis, 27 were positive for HIV, 25 for Chagas and 3 for Hepatitis B. At the moment, all the newborns were free of the four diseases. The social profitability evaluation was very high. Lessons Public-private associations could be an innovative way to deal with some major public health issues. EMTCT Plus is a useful framework for Latin American countries. The social profitability of investments in the elimination of mother to child transmission is very high. Key messages Elimination of Mother-to-Child Transmission of HIV, Syphilis, Chagas and Hepatitis B is a useful framework for Latin American countries. The social profitability evaluation was very high. Public-private associations could be an innovative way to deal with some major public health issues.