Campaign to End Pediatric HIV/AIDS Launched
Will Boost AIDS Prevention and Treatment in Six African Nations
Oct 27, 2009
Around the world, 2.1 million children under the age of 15 are living with HIV/AIDS. An estimated 1.8 million of them are in sub-Saharan Africa, the region hardest hit by the pandemic.
But only one in seven children who need treatment with life-saving antiretroviral drugs receive it. Mortality among HIV-infected children is extremely high. And only about a third of pregnant women with HIV are treated to prevent them from passing the virus to their infants.
Global AIDS Alliance Urges Action
In Johannesburg, South Africa, on Oct. 22, 2009, the Global AIDS Alliance launched a three-year Campaign to End Pediatric HIV/AIDS. The campaign, known as CEPA, will focus initially on six countries: Kenya, Mozambique, Nigeria, Tanzania, Uganda, and Zambia. It will later expand to other countries and regions of the world.
CEPA will provide resources to civil society organizations to ramp up advocacy in the six focus countries, pressing national governments for increased attention to pediatric HIV/AIDS. The campaign will also push for greater resources and response from international agencies and wealthy nations.
At the CEPA launch, activist Graça Machel warned of the “potential human, social, and economic devastation of Africa’s future generations” as a consequence of HIV/AIDS among African children. Machel, who is married to Nelson Mandela, called on African leaders to do all in their power to end pediatric AIDS on the continent.
Two-Pronged Strategy
Combating HIV/AIDS in children requires action to:
- prevent parent-to-child transmission, in which a mother with HIV passes the virus to her infant during pregnancy, labor and delivery, or breastfeeding; and
- diagnose and treat HIV-infected children at a young age.
Both approaches have been shown to work. Since 2003, the rate of annual AIDS deaths among children has begun to fall because of scaled-up prevention and treatment. Even so, only 30 to 40 percent of women and children who need HIV services have access to them.
CEPA seeks to raise that level to 80 percent. The barriers include a lack of financing and lack of clear national policies and targets.
Preventing Parent-to-Child Transmission
More than 90 percent of children with HIV acquired the virus from their mothers (many of whom, in turn, were infected by their husbands). Without intervention, up to 45 percent of infants born to HIV-positive mothers will become infected.
There were 370,000 new pediatric HIV infections in 2007 alone, according to the World Health Organization and UNAIDS.
Treating HIV-positive pregnant women with antiretroviral drugs and counseling them on the feeding of their newborns can sharply reduce mother-to-child transmission of the virus. There has been progress in expanding coverage, but two-thirds of infected pregnant women are still not being reached.
Their children are born under a virtual death sentence. Without antiretroviral treatment, one-third of HIV-infected children die by the age of one year, and half by age two. And many who do survive become orphans when their mothers die of AIDS.
Treating AIDS in Children
Mortality levels among infants born to infected mothers can be reduced by up to 75 percent when babies are tested within six weeks of birth and treated within the first 12 weeks. But in 2007, only 10 percent of children born to HIV-positive women were tested before they were two months old.
According to UNAIDS, children are much less likely than adults to receive antiretroviral medicines. HIV is more difficult to diagnose in children, although pediatric diagnostic tools have recently become available. Available antiretroviral drugs were initially developed for adults, and most standard fixed-dose combinations are not suited for children. But these problems can be overcome.
AIDS in Africa
Sub-Saharan Africa accounted for 72 percent of worldwide AIDS deaths in 2007. Eastern and Southern Africa, the worst hit, are home to 1.3 million HIV-infected children.
Three of the CEPA countries, Kenya, Uganda, Tanzania, have already made some progress in scaling up pediatric HIV/AIDS services. In Uganda and Tanzania about a third of infected pregnant women were being treated in 2007, and in Kenya more than two-thirds were.
The other three countries, Nigeria, Zambia, and Mozambique, have lagged. Nigeria, Africa’s most populous nation, has the third-largest number of HIV-infected people in the world. Approximately 200,000 pregnant women in Nigeria were living with HIV in 2007, but only about 7 percent of them were receiving antiretroviral therapy.
South Africa has more HIV-positive people than any other country, including an estimated 220,000 infected pregnant women. But South Africa has greater internal resources than most African countries. The government has made progress in the last few years in expanding prevention and treatment, with 57 percent of HIV-infected pregnant women receiving antiretrovirals in 2007.
Sources
Global AIDS Alliance, “Campaign to End Pediatric Aids Launched in Six African Countries,” press release, October 22, 2009
UNAIDS, 2008 Report on the Global AIDS Epidemic
UNICEF, UNAIDS, and WHO, Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector: Progress Report 2008
UNICEF, WHO, UNAIDS, and UNFPA, Children and AIDS: Third Stocktaking Report, 2008
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