30 November 2010 Although 370,000 children are born with HIV each year, achieving an AIDS-free generation is possible if the world steps up efforts to provide universal access to prevention, treatment and social protection, according to a new United Nations report released today.
But attaining this goal depends on reaching the most marginalized members of society, the report – Children and AIDS: Fifth Stocktaking Report 2010 – warns, noting that millions of women and children have fallen through the cracks due to inequities rooted in gender, economic status, geographical location, education level and social status.
“To achieve an AIDS-free generation we need to do more to reach the hardest hit communities,” UN Children’s Fund (UNICEF) Executive Director Anthony Lake said in New York in launching the report, compiled jointly by his agency, the Joint UN Programme on HIV/AIDS (UNAIDS), the UN Educational, Scientific and Cultural Organization (UNESCO), the UN Population Fund (UNFPA) and the UN World Health Organization (WHO).
“Every day, nearly 1,000 babies in sub-Saharan Africa are infected with HIV through mother-to-child transmission. Our Fifth Stocktaking Report on Children and AIDS highlights innovations like the Mother Baby Pack that can bring life-saving ARV (antiretroviral drugs) treatment to more mothers and their babies than ever before.”
Such treatment prevents mother-to-child transmission (PMTCT). AIDS is one of the leading causes of death among women of reproductive age globally and a major cause of maternal mortality in countries with generalized epidemics. In sub-Saharan Africa, 9 per cent of maternal mortality is attributable to HIV and AIDS.
“Around 370,000 children are born with HIV each year. Each one of these infections is preventable,” UNAIDS Executive Director Michel Sidibé said. “We have to stop mothers from dying and babies from becoming infected with HIV. That is why I have called for the virtual elimination of mother-to-child transmission by 2015.”
WHO revised its guidelines earlier this year, to ensure quality PMTCT services for HIV-positive pregnant women and their infants. In low- and middle-income countries, 53 per cent of pregnant women living with HIV received ARVs to prevent mother-to-child transmission in 2009 compared to 45 per cent in 2008. One of the most significant increases occurred in eastern and southern Africa, where the proportion jumped 10 percentage points, from 58 per cent in 2008 to 68 per cent in 2009.
“We have strong evidence that elimination of mother-to-child transmission is achievable,” WHO Director-General Margaret Chan said. “Achieving the goal will require much better prevention among women and mothers in the first place.”
WHO also issued new ARV guidelines for treating infants and children, paving the way for many more children with HIV to be eligible for immediate antiretroviral treatment (ART).
In low- and middle-income countries, the number of children under the age of 15 who received treatment rose from 275,300 in 2008 to 356,400 in 2009. This increase means that 28 per cent of the 1.27 million children estimated to be in need of ART receive it.
Infants are particularly vulnerable to the effects of HIV, which has lent urgency to the global campaign for early infant diagnosis. While the availability of early infant diagnosis services has increased dramatically in many countries, global coverage still remains low, at only 6 per cent in 2009. Without treatment, about half of the infected infants die before their second birthday.
In most parts of the world, new HIV infections are steadily falling or stabilizing. In 2001, an estimated 5.7 million young people aged 15–24 were living with HIV. At the end of 2009, that number fell to 5 million. However, in nine countries – all of them in southern Africa – at least 1 in 20 young people is living with HIV.
Young women still shoulder the greater burden of infection, and in many countries women face their greatest risk of infection before age 25. Worldwide, more than 60 per cent of all young people living with HIV are female. In sub-Saharan Africa, that figure is nearly 70 per cent.
“We need to address gender inequalities, including those that place women and girls at disproportionate risk to HIV and other adverse sexual and reproductive health outcomes,” UNESCO Director General Irina Bokova said. “While we are encouraged by a decline in HIV incidence among young people of more than 25 per cent in 15 key countries in sub-Saharan Africa between 2001 and 2009, we must do everything possible to sustain and increase such positive trends in order to achieve universal access to prevention, treatment, care and support.”
Adolescents are still becoming infected with HIV because they have neither the knowledge nor the access to services to protect themselves. “We must increase investments in young people’s education and health, including sexual and reproductive health, to prevent HIV infections and advance social protection,” UNFPA Executive Director Thoraya Ahmed Obaid said.
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