University of Pennsylvania School of Medicine, Division of Infectious Diseases, 3400 Spruce St, Philadelphia, PA 19104, United States of America (USA).
Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland.
Bull World Health Organ. 2021 Apr 1;99(4):287-295. doi: 10.2471/BLT.20.272559. Epub 2021 Jan 21.
Triple elimination is an initiative supporting the elimination of mother-to-child transmission of three diseases - human immunodeficiency virus (HIV) infection, syphilis and hepatitis B. Significant progress towards triple elimination has been made in some regions, but progress has been slow in sub-Saharan Africa, the region with the highest burden of these diseases. The shared features of the three diseases, including their epidemiology, disease interactions and core interventions for tackling them, enable an integrated health-systems approach for elimination of mother-to-child transmission. Current barriers to triple elimination in sub-Saharan Africa include a lack of policies, strategies and resources to support the uptake of well established preventive and treatment interventions. While much can be achieved with existing tools, the development of new products and models of care, as well as a prioritized research agenda, are needed to accelerate progress on triple elimination in sub-Saharan Africa. In this paper we aim to show that health systems working together with communities in sub-Saharan Africa could deliver rapid and sustainable results towards the elimination of mother-to-child transmission of all three diseases. However, stronger political support, expansion of evidence-based interventions and better use of funding streams are needed to improve efficiency and build on the successes in prevention of mother-to-child transmission of HIV. Triple elimination is a strategic opportunity to reduce the morbidity and mortality from HIV infection, syphilis and hepatitis B for mothers and their infants within the context of universal health coverage.
三病母婴阻断消除行动旨在消除三种疾病（艾滋病毒、梅毒和乙型肝炎）经母婴传播。在一些地区，三病母婴阻断消除行动取得了显著进展，但在受这些疾病影响最大的撒哈拉以南非洲地区进展缓慢。这三种疾病具有共同特征，包括流行病学、疾病相互作用以及核心干预措施，这些都为消除母婴传播提供了综合的卫生系统方法。目前，撒哈拉以南非洲地区三病母婴阻断消除行动面临的障碍包括缺乏政策、战略和资源来支持广泛采用既定的预防和治疗干预措施。虽然可以利用现有工具取得很大进展，但需要开发新产品和护理模式，并制定优先研究议程，以加快撒哈拉以南非洲地区三病母婴阻断消除的进展。本文旨在表明，撒哈拉以南非洲地区的卫生系统与社区携手合作，可以迅速取得可持续的成果，消除所有三种疾病的母婴传播。然而，需要更强有力的政治支持、扩大基于证据的干预措施以及更好地利用资金流，以提高效率，并在预防艾滋病毒母婴传播方面的成功基础上再接再厉。三病母婴阻断消除行动是一个战略机遇，可以在全民健康覆盖的背景下，减少艾滋病毒、梅毒和乙型肝炎对母亲及其婴儿的发病率和死亡率。
