Early diagnosis and treatment can significantly improve the prospects for survival of newborn babies exposed to HIV, according to a report released today by four United Nations agencies.
The report, titled Children and AIDS: Third stocktaking report, was jointly prepared by UNICEF, the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Population Fund (UNFPA) and released on World Aids Day.
“Without appropriate treatment, half of children with HIV will die from an HIV-related cause by their second birthday,” said Ann M. Veneman, UNICEF Executive Director. “Survival rates are up to 75 per cent higher for HIV-positive newborns who are diagnosed and begin treatment within their first 12 weeks.”
However, in 2007, less than 10 per cent of infants born to HIV-positive mothers were tested for HIV before they were two months old. The report advocates for increased testing to enable appropriate treatments to begin as early as possible.
“Today, no infant should have to die of AIDS,” said WHO Director-General Dr. Margaret Chan. “We know how to prevent these tragic deaths, but now we need to focus on strengthening our healthcare systems to ensure that all mothers and children receive treatment as early as possible.”
Early infant testing in some of the countries hardest hit by HIV and AIDS, such as Kenya, Malawi, Mozambique, Rwanda, South Africa, Swaziland and Zambia, is being scaled up. In 2007, 30 low- and middle-income countries were using dried blood spot filter testing, up from 17 countries in 2005. In several countries in sub-Saharan Africa, including Botswana and South Africa, many infants are now tested for HIV at as young as six weeks of age, using dried blood spot testing, and many of those who test positive are provided antiretroviral therapy.
Far too few pregnant women know their HIV status. In 2007, only 18 per cent of pregnant women in low- and middle-income countries were given an HIV test, and of those who tested positive, only 12 per cent were further screened to determine the stage of HIV disease and the type of treatment they require.
“The prevention of mother-to-child transmission of HIV is not only effective, but also a human right,” said UNAIDS Executive Director Dr. Peter Piot. “We are seeing good progress in many countries, especially in parts of Africa, but we need to significantly scale up HIV testing and treatment for pregnant women.”
The report also recommends increased access to tests assessing immune functions of HIV-positive mothers to determine their stage of HIV disease and provide a basis for decisions about appropriate treatment that addresses their own health needs and reduces the chance of the virus being passed to their offspring.
Addressing prevention is also a key part of the UN strategy on HIV and AIDS. Significant numbers of young people continue to be infected with HIV each year – 45 per cent of all new infections occur in the 15- 24 year-old age group. Young people are a component of national HIV strategic plans in 22 countries in West and Central Africa. In Cameroon, the Democratic Republic of the Congo and Nigeria, there are programmes that focus on reducing risky behaviours, vulnerability and disparity among young people both in school and out of school.
“In a world with HIV and AIDS, young people need comprehensive information and education and access to sexual and reproductive health services to protect their right to health,” said Thoraya Ahmed Obaid, UNFPA’s Executive Director. “Preventing HIV infection in women is the first line of defence in preventing HIV in newborns. Involving young people in HIV efforts is the best way to ensure that programmes are well-targeted and effective.”
Pediatric AIDS treatment, prevention of mother-to-child transmission and prevention of new infections among adolescents and young people are three of the four core components of Unite for Children, Unite against AIDS discussed in the Stocktaking report. The last section advocates for expanded protection and care for the approximately 15 million children globally who have lost either one or both of their parents due to AIDS, sparking greater attention to the needs of all vulnerable children.
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Background on Unite for Children, Unite against AIDS
The report, Children and AIDS: Third stocktaking report is the third 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.
Dry blood spot testing (DBS) allows for collection of blood specimens when the cold chain is not available, and testing facilities are not available on site, as is the case in most low- and middle-income resource settings. Using DBS allows health providers to transport blood specimens collected locally in facilities where the infant receives routine health care including first year health interventions (such as immunization clinics) to laboratories with testing capacity.
The report also outlines solutions to ensure that health care is delivered to mothers and to their children:
– Scale up programmes that provide early diagnosis of infants exposed to HIV and treatment of infected children.
– Expand access to antiretroviral drugs for pregnant women in need of treatment.
– Integrate HIV and AIDS services with primary-health-care programmes.
– Accelerate efforts to support mothers on optimal and safe infant and young child feeding practices.
– Make prevention programmes more relevant to the needs of adolescents and young people.
– Prioritize the collection and disaggregation of high-quality data.
– Invest in the social sector to improve protection of the most vulnerable children.
– Combine prevention strategies for a more effective response.
– Understand and address the greater vulnerability of girls.
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