By Shamiso Yikoniko in Kigali, Rwanda
A groundbreaking diagnostic tool recently prequalified by the World Health Organization (WHO) is set to revolutionize efforts to eliminate mother-to-child transmission (MTCT) of three major infections: HIV, syphilis, and hepatitis B. Dubbed the “Triple Elimination Test,” the innovative tool adopts a ‘one visit, one test, three results’ approach, allowing healthcare providers to screen for all three infections using just one blood sample — with results available within 20 to 30 minutes.
Previously, expectant mothers in many low-resource settings had to return to clinics multiple times and undergo separate tests, often resulting in treatment delays and increased dropout from care. The new triple test aims to simplify antenatal screening and reduce these barriers to care.
[pullquote]Triple Elimination Test offers a faster diagnosis, timely treatment, cost-effectiveness, higher compliance, and reduces stigma.[/pullquote]
HIV, syphilis, and hepatitis B continue to pose a significant public health burden for mothers and newborns. According to WHO data from 2022, an estimated 1.4 million women living with HIV become pregnant each year. Without timely intervention, up to 5 percent of HIV-exposed infants die within the first six months of life. Additionally, 1.1 million maternal syphilis infections occur globally each year, with 21 percent leading to stillbirths or neonatal deaths. Hepatitis B affects around 75 million women of reproductive age, and when transmitted from mother to child, 95 percent of infants become chronically infected. One in four of those infected faces the risk of premature death due to liver-related complications.
Dr. Angela Mushavi, the National Coordinator for Prevention of Mother-to-Child Transmission (PMTCT) in Zimbabwe’s Ministry of Health and Child Care, welcomed the development, calling it a “game changer.”
We have seen the benefits of combining tests through the dual HIV/syphilis test. The triple test takes this a step further and is transformative for PMTCT—not only for expectant mothers but also for the health workers who serve them,” said Dr. Mushavi at the 13th International AIDS Conference in Kigali, Rwanda.
“By simplifying testing, we can ensure more women are diagnosed early and can begin life-saving treatment without delay,” she added. “Before the dual test was introduced, Zimbabwe had a 95 percent testing rate for HIV among pregnant women and only 70 percent for syphilis. Since introducing the dual test, these figures have increased to 99 percent for HIV and 93 percent for syphilis as of 2024. So you can imagine the impact this triple test will have.”
The triple test allows for immediate initiation of antiretroviral therapy (ART) for HIV, penicillin for syphilis, and hepatitis B prophylaxis. This streamlined care approach drastically reduces the risk of transmission to newborns and supports WHO’s broader goal of triple elimination of MTCT for all three infections by 2030.
“The triple elimination strategy is not just about testing,” emphasized Dr. Mushavi. “It’s about ensuring that every pregnant woman receives comprehensive care in a seamless and efficient process. This is how we close critical gaps in care and safeguard future generations.”
To date, WHO has prequalified three dual HIV/syphilis rapid diagnostic tests and continues to evaluate a pipeline of multiplex diagnostics. The newly prequalified triple test builds on the success of dual tests and aligns with existing WHO guidelines, aiming to increase access to integrated antenatal screening.
