More HIV-positive children and pregnant women are receiving treatment but there is still a long way to go before the promise of an AIDS-free generation is fulfilled, according to a United Nations report released today.
Children and AIDS: Second stocktaking report is a review of progress on how AIDS affects children and young people. Unite for Children, Unite against AIDS, which was launched in October 2005 by the Joint United Nations Programme on HIV/AIDS (UNAIDS), UNICEF and other partners, was a call to action around the impact of HIV and AIDS on children.
“Today’s children and young people have never known a world free of AIDS,” said UNICEF Executive Director Ann M. Veneman. “Thousands lose their lives to the disease every year, and millions have lost parents and caregivers. Children must be at the heart of the global AIDS agenda.”
Produced by UNAIDS, the World Health Organization (WHO) and UNICEF, the report reviews the progress made – and the challenges remaining – in four key areas: preventing HIV transmission from mothers to children (PMTCT), providing paediatric treatment, preventing infection among adolescents and young people, and protecting and supporting children affected by AIDS. The report focuses on low- and middle-income countries.
According to the report, in 2007, an estimated 290,000 children under 15 died from AIDS, and 12.1 million children in sub-Saharan Africa lost one or both parents to AIDS.
However by the end of 2006, 21 countries – including Benin, Botswana, Brazil, Namibia, Rwanda, South Africa and Thailand – were on track to meet the Unite for Children: Unite Against AIDS target of 80 per cent coverage for PMTCT by 2010, up from only 11 countries in 2005.
In addition, the number of HIV-positive children in low- and middle-income countries receiving antiretroviral treatment increased by 70 per cent from 2005 to 2006.
"Important gains have been made in addressing treatment needs for children and in preventing mother-to-child transmission of HIV," said UNAIDS Executive Director Dr. Peter Piot. "However much more needs to be done to prevent HIV amongst young people and adolescents if we are to make a major change in the direction of the epidemic."
Indicators show progress on the protection and care for children affected by AIDS in many countries and on access for these children to social services. Progress has also been made in school enrolment rates for children who have lost both parents to the disease, although AIDS-affected children are still more likely than other children to fall behind in school and to live in poorer households.
Since 2000-2001, in 11 of 15 countries for which sufficient data are available, HIV prevalence among pregnant women aged 15-24 attending antenatal clinics has declined.
The proportion of HIV-positive pregnant women receiving antiretrovirals to reduce the risk of transmitting the virus to their infants increased by 60 per cent from 2005 to 2006, but even with this increase, it is estimated that only 23 per cent of HIV-positive pregnant women are receiving antiretrovirals.
"We are making progress but still face many challenges," says Dr. Kevin DeCock, Director of the World Health Organization's HIV Division. "Critically, we must provide antiretroviral treatment for women who require it for their own health, which will save their lives but also assure a future for their children. To achieve all this, health systems and their most precious component, the health care workforce, must be strengthened."
Most of the 2.1 million children under 15 living with HIV in 2007 were infected before their birth, during delivery or while breastfeeding. And young people aged 15-24 still account for about 40 per cent of the new HIV infections among all people over 15 in 2007.
While the news is mixed, the report argues that achieving an AIDS-free generation is possible. Although funding gaps persist, governments and donors alike are allocating more resources to prevention, treatment and protection efforts. In 2007, some $10 billion were available to combat AIDS, up from $6.1 billion in 2004.
The priority is now to implement new initiatives and scale up those that have already been tested and proven effective.
The report calls for action to:
• Strengthen communities and families whose role is crucial to every aspect of a child-centered approach to AIDS
• Reinforce health, education and social welfare systems which are key to effective interventions to support children affected by HIV and AIDS
• Integrate services for the prevention of mother-to-child transmission in maternal, newborn and child health-care programmes
• Consolidate data and measurement in order to document advances and shortfalls and strengthen commitment.