Work to eliminate mother-to-child transmission of HIV and syphilis means Bermuda held its place among a small group of countries to be internationally recognised for the achievement.The Ministry of Health revealed today that the island was revalidated with EMTCT status after its initial certification in June 2017.It added that the status was a “prestigious public health accomplishment” achieved by only 11 countries worldwide. Kim Wilson, the Minister of Health, said: “We were delighted and very proud of that achievement.“However, once achieved, EMTCT must be maintained. “EMTCT validation indicates that Bermuda is proficient at preventing mother-to-child transmission of these infections. “Good antenatal care, early testing for HIV and syphilis and treatment for HIV positive mothers can prevent transmission of HIV from an HIV-positive mother to her infant during pregnancy, labour, delivery, or breastfeeding.“However, HIV remains a threat and complacency is especially dangerous. “Both HIV and congenital syphilis have serious implications for the lives of babies and can be prevented. Hence, the importance of maintaining elimination status.”The ministry explained that validation of elimination status was made by a special committee of the World Health Organisation, which assesses a country’s systems to check for HIV and syphilis in pregnancy, its laboratory capacity for accurate testing and access to antenatal care for all adolescents and women.The committee also looks at private and public healthcare collaboration as well as care quality.Countries must demonstrate to Global Validation Advisory Committee standards that the country’s programmes and procedures can be relied upon to identify early and treat cases of the diseases during pregnancy. The standards do not require that the conditions are absent in a community, but countries must show that pregnant women are adequately tested and cared for.Programme indicators confirmed that in Bermuda more than 95 per cent of pregnant women are tested early in pregnancy for HIV and syphilis.To meet the requirement for both diseases, a country must show:• That the rate of mother-to-child transmission of HIV was less than 2 per cent;• New cases of HIV infection in infants were less than 0.3 per 1000 live births annually;• Cases of congenital syphilis of less than 0.5 per 1,000 live births each year.Ms Wilson said: “In September, Bermuda sent the required maintenance report to GVAC. “Our report indicated both the processes used in Bermuda to assure all babies and mothers are tested for HIV and syphilis and provided necessary treatment to prevent mother-to-baby transmission. “In addition, we provided feedback on how Bermuda had responded to the recommendations made by the committee during the initial validation visit in June 2017.“In order to prepare a maintenance report required an enormous amount of work on the part of the ministry to collect data from Bermuda Hospitals Board, Register General and Epidemiology and Surveillance Unit.“We are particularly grateful for the generous collaborations with Department of Health and BHB professionals who played a critical role in this achievement by providing an enormous amount of clinical information.”The ministry said that the GVAC told health officials this month that Bermuda was “in a very strong position to continue to maintain validation of EMTCT of HIV and syphilis”.It highlighted the island’s “strong expertise and commitment” to the elimination of mother-to-child transmission of the diseases and commended Bermuda for “these national, regional and global achievements”.The next review for maintenance of validation of EMTCT will be September 2021.