An AIDS-Free Generation is achievable by focusing on the most disadvantaged communities affected by HIV, says a new U.N. report marking World AIDS Day
NEW YORK, 30 November 2010 - 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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