South Africa and Botswana have reduced mother-to-child HIV transmission rates to less than 5%.
Imagine a world in which all children are born free of HIV and in which those living with HIV receive the treatment and care they need.
Imagine a world in which all children can grow up to fulfil their potential without the risk of Aids.
Today, this dream of an Aids-free generation is at last within reach.
Children and Aids: The Sixth Stocktaking Report, recently released by the United Nations Children’s Fund (Unicef), shows that more than 850 000 new HIV infections among children were averted between 2005 and 2012 in the developing world.
This was due to global and national efforts to make treatment and other services available for pregnant women living with HIV.
South Africa and Botswana have reduced mother-to-child HIV transmission rates to less than 5%. The means to do this in other Eastern and Southern African countries exists.
In sub-Saharan Africa, new HIV infections among children have been halved in the last decade (from 500 000 new infections in 2001 to 230 000 new infections in 2012).
The reason is clear: pregnant women living with HIV now have much greater access to services to prevent mother-to-child transmission.
In Eastern and Southern Africa, service uptake reached 75% in 2012, up from just 17% in 2005. But much remains to be done.
Despite the progress made in low- and middle-income countries toward eliminating new infections, children who do contract HIV are far less likely than adults to receive the treatment they need.
Only 34% of children living with the virus are treated, compared to 64% of adults.
And every day in 2012, nearly 600 children died from Aids-related causes. Every one of these deaths was preventable.
Older children, too, need more from us. In Eastern and Southern Africa, new HIV infections among adolescents between the ages of 10 and 19 continue to rise at an alarming rate.
In 2012, 160 000 adolescents were newly infected with the virus.
Adolescents are the only age group in which Aids-related deaths have increased, despite promising signs of behaviour change: they use condoms more frequently and wait longer for their first sexual experience.
Even so, Aids-related deaths among adolescents increased by 50% between 2005 and 2012, in sharp contrast with a 30% global drop in Aids-related deaths. This group is often overlooked in the overall response to HIV, both at national and at global levels.
Reaching those in need
Unicef organises its HIV prevention work around the first and second decades of a child’s life — each with its own different conditions and needs. Our new report shows clearly what must be done. To capitalise on the successes so far, more work is needed in both decades.
We must reduce the number of new infant infections to zero. Women and girls — tomorrow’s mothers — need access to contraception, including condoms, to protect themselves from acquiring HIV.
They must also have greater control over their sexual health and family planning. And women living with the virus need antiretroviral medicines to stay healthy and avoid transmitting HIV to their babies during pregnancy, childbirth or breastfeeding.
For adolescents, access to testing, counselling and treatment must be made available through programmes that take into account this group’s unique needs and offer a protective and safe environment.
The world now has the knowledge, experience and means to achieve an Aids-free generation. Paradoxically, those we most need to reach to realise this goal are also those hardest to reach: the most vulnerable and marginalised children, adolescents and women.
Increased and targeted investments, innovative approaches, a decrease in HIV stigma and new ways of working can all make this possible. Now is the time to make the dream of an Aids-free generation a reality for every child.
www.childrenandaids.org
This article forms part of a supplement paid for by Unicef. Contents and photographs were supplied and signed off by Unicef