NEW YORK—Achieving an AIDS-free generation is possible if the international community steps up efforts to provide universal access to HIV prevention, treatment, and social protection, according to “Children and AIDS: Fifth Stocktaking Report 2010,” which was released today in New York. Attaining this goal, however, depends on reaching the most marginalized members of society.
While children in general have benefited enormously from the substantial progress made in the AIDS responses, there are millions of women and children who have fallen through the cracks due to inequities rooted in gender, economic status, geographical location, education level and social status. Lifting these barriers is crucial to universal access to knowledge, care, protection, and the prevention of mother-to-child transmission (PMTCT) for all women and children.
“To achieve an AIDS-free generation we need to do more to reach the hardest hit communities. Every day, nearly 1000 babies in sub-Sarahan Africa are infected with HIV through mother to child transmission,” said Anthony Lake, UNICEF’s Executive Director. “Our Fifth Stocktaking Report on Children and AIDS highlights innovations like the Mother Baby Pack that can bring life-saving ARV treatment to more mothers and their babies than ever before,” said Lake.
The World Health Organization (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 antiretrovirals (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 ten percentage points, from 58 in 2008 to 68 per cent in 2009.
“We have strong evidence that elimination of mother-to-child transmission is achievable," said Dr Margaret Chan, WHO’s Director-General. “Achieving the goal will require much better prevention among women and mothers in the first place.”
AIDS is still 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,” said Michel Sidibé, Executive Director, UNAIDS. “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 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 an 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 infants infected with HIV 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” said Irina Bokova, Director General of UNESCO. “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. Attaining an AIDS-free generation means erasing the inequities that fuel the epidemic and protecting those who continue to fall through the cracks. Social protection initiatives – including cash transfers and efforts to promote access to services – play an important role in breaking the cycle of vulnerability. The report also emphasizes the importance of tailoring education programmes to target the most vulnerable youths – those who are out of school – with information about HIV prevention.
“We must increase investments in young people’s education and health, including sexual and reproductive health, to prevent HIV infections and advance social protection," said Thoraya Ahmed Obaid, Executive Director of UNFPA, the United Nations Population Fund. “Reaching marginalized young people, including vulnerable adolescent girls and those who are not in school, must remain a priority”.
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Background on Unite for Children, Unite against AIDS:
The report, Children and AIDS: Fifth stocktaking report is the fifth review of progress on how AIDS affects children and young people since Unite for Children, Unite against AIDS was launched in October 2005 by UNICEF, UNAIDS and other partners with a commitment to be accountable for results. Unite for Children, Unite against AIDS is a call to action around the impact of HIV and AIDS on children. It focuses on the needs of children in four key areas, known as the “Four Ps”: preventing mother-to-child transmission of HIV, providing paediatric treatment for children infected with the virus, preventing new infections among adolescents and young people, and protecting and supporting children affected by HIV and AIDS.
UNAIDS is an innovative joint venture of the United Nations, bringing together the efforts and resources of the UNAIDS Secretariat and ten UN system organizations in the AIDS response. The Secretariat headquarters is in Geneva, Switzerland – with staff on the ground in more than 80 countries. Coherent action on AIDS by the UN system is coordinated in countries through UN theme groups, and joint programmes on AIDS. UNAIDS’ Cosponsors include UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, ILO, UNESCO, WHO and the World Bank. http://www.unaids.org/
As the directing and coordinating authority on international health, the World Health Organization (WHO) takes the lead within the UN system in the global health sector response to HIV/AIDS. The HIV/AIDS Department provides evidence-based, technical support to WHO Member States to help them scale up treatment, care and prevention services as well as drugs and diagnostics supply to ensure a comprehensive and sustainable response to HIV/AIDS. http://www.who.int/
UNFPA, the United Nations Population Fund, is an international development agency that promotes the right of every woman, man and child to enjoy a life of health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect. http://www.unfpa.org/
UNESCO takes the lead within the UN system on HIV prevention with young people in the education system, in support of the UNAIDS commitment to universal access to comprehensive HIV prevention programmes, treatment, care and support. The UNAIDS Global Initiative on HIV and AIDS and Education (EDUCAIDS), led by UNESCO, has two primary aims: to prevent the spread of HIV through education and to protect the core functions of the education system from the impact of the epidemic. A key focus of UNESCO’s work is leadership in the area of comprehensive sexuality education, as a means of strengthening HIV prevention. For more information on UNESCO’s response, see www.unesco.org/aids
UNICEF is on the ground in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. http://www.unicef.org/
Sophie Barton-Knott, UNAIDS Geneva; + 41 22 791 1697, firstname.lastname@example.org
Tunga Namjilsuren, WHO Geneva; + 41 79 203 3176, email@example.com
Omar Gharzeddine, UNFPA New York; + 1 212 297 5028, firstname.lastname@example.org
Victoria Kalinin, UNESCO Paris; + 33 1 45 68 18 46, email@example.com