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Progress Against Tetanus, H.I.V. and Malaria

The Americas has eliminated maternal and neonatal tetanus (MNT), a disease that used to be responsible for the deaths of more than 10,000 newborns every year in the Americas.

The elimination of the disease was declared this year in Haiti, which made it possible to reach the regional goal. MNT is the sixth vaccine-preventable disease to be eliminated from the Americas, following the regional eradication of smallpox in 1971, poliomyelitis in 1994, rubella and congenital rubella syndrome in 2015, and measles in 2016.

“The elimination of maternal and neonatal tetanus is proof again that vaccines work to save the lives of countless mothers and babies,” said Carissa F. Etienne, director of the Pan American Health Organization/World Health Organization (PAHO/WHO). “Let us continue to protect the people of our Region by investing in strong national immunization programs that are capable of vaccinating all individuals and quickly identifying vaccine-preventable diseases.”

Unlike other vaccine-preventable diseases, MNT is considered eliminated when there is an annual rate of less than one case of neonatal tetanus per 1,000 live births at the district level. Tetanus cannot be fully eradicated because the bacterium that causes the disease, Clostridium tetani, exists throughout the environment in soil and the feces of many different animals.

Before widespread modern vaccination against MNT began in the 1970s, neonatal tetanus was responsible for the deaths of more than 10,000 newborns every year in the Americas – a number considered low by experts due to severe underreporting of cases. According to data from WHO, neonatal tetanus killed about 34,000 newborn children in 2015, a 96% reduction from 1988, when an estimated 787,000 newborn babies died of tetanus within their first month of life.

This was one of several significant global health advances, including new programs against malaria and H.I.V., announced last week in conjunction with the meeting of the United Nations General Assembly in New York.

A combination of aid agencies, drug companies and governments also announced that a new three-in-one antiretroviral cocktail to treat H.I.V. would soon be available to 92 countries, including virtually all of Africa, for about $75 a year.

The new AIDS cocktail is the first available in poor countries to contain dolutegravir, which is widely used in wealthy countries because it is highly effective and has few side effects.

Almost 37 million people in the world have H.I.V., according to Unaids, the U.N.’s AIDS-fighting agency, but fewer than 20 million are now on antiretroviral medicine, which not only saves their lives but prevents them from passing on the disease.

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