HIV/AIDS: Looking forward to an AIDS-free generation
AIDS-free generation by 2015
NEW YORK, 1 December 2010 (IRIN) - Achieving an HIV-free generation by 2015 is feasible, but will require innovative approaches to reach marginalized populations, says the UN Children’s Fund (UNICEF).
Attaining virtual elimination – meaning fewer than 5 percent of babies born to HIV-positive pregnant mothers contract the virus – will not require new scientific breakthroughs, said Jimmy Kolker, HIV/AIDS chief of UNICEF. Innovative financing and outreach are needed to enable people, especially women, youth and infants, to take advantage of available HIV prevention and treatment therapy.
“If you look at current programmes, we don't have enough money to do the kinds of dramatic increases and innovations we need to make these programmes actually result in an AIDS-free generation by 2015,” Kolker told IRIN/PlusNews before the official launch of Children and AIDS: Fifth Stocktaking Report
, at UNICEF headquarters on 30 November.
“We do need to think differently about children and AIDS, especially the prevention of mother-to-child transmission
PMTCT programmes have been significantly scaled up in countries such as Tanzania, Kenya, Mozambique, Malawi, Rwanda and Lesotho, which are set to achieve “universal access”
of treatment for HIV and AIDS, reaching 80 percent of the affected population in need, by next year. But that has not translated into a steep decline in babies born HIV-positive.
While antiretroviral (ARV) treatment for HIV-positive pregnant women expanded from 45 percent in 2008 to 53 percent in 2009, infants born to these women did not experience a comparable jump in coverage, increasing only from 32 percent in 2008 to 35 percent in 2009.
About 370,000 infants are born with HIV each year.
Kolker called the significant drop-off between the two rates of expectant mothers and infants receiving ARV treatment “disturbing”, attributed in part to mothers who give birth at home, without access to a health clinic. There is also the stigma factor, as some women fear exposing their children to judgment.
“The number of infants who are exposed to HIV from positive mothers and come back for testing within the first 12 weeks of life is very low. Not thinking that PMTCT ends at birth is a very important element,” said Kolker.
The figure for under-15s shows more improvement, with a rise from 22 percent of children in low- and middle-income countries receiving ARV therapy in 2008 to 28 percent in 2009.
The recent introduction of UNICEF's “mother-baby packs
” could make it easier to bring ARV therapy to infants in remote areas. The comprehensive take-home ARV kits could fill the role of health clinic visits, testing and possible treatment.
Ninety percent of mother-to-child-transmission cases occur in sub-Saharan Africa and the pilot phase of the mother-baby packs is under way.
Ten thousand packs, which cost US$70 each, have been distributed in Kenya and Zambia and 30,000 additional packs will go out in 2011 to expectant HIV-positive mothers in their 14th week of pregnancy. UNICEF has raised $8 million for the pilot project and expects to raise several million more within the next year so the packs will be free.
The packs mark the kind of innovative thinking – and financing – that UN health officials say will be necessary in future.
“The biggest problem we are going to face is availability of resources,” George Tembo, HIV/AIDS chief of the UN Population Fund (UNFPA), told IRIN/PlusNews. “There's a huge shortfall and we are thinking about innovative ways of financing. In as much as it is important to have donors put in more money, increasingly national governments will need to put more and more of their resources into HIV for prevention and treatment.”
The total number of young people aged 15-24 living with HIV has dropped since 2001, however, from 5.7 million to 5.0 million by the end of 2009. The report attributes the decline to safer sex practices.