Children running home after attending a Circle of Dialogue meant to encourage discussion about important social issues such as health
In its 2013 Stocktaking Report on Children and Aids released on November 29, the United Nations Children’s Fund (Unicef) states that great progress has been made to prevent mother-to-child transmission of HIV.
It found that more than 850 000 new childhood infections were averted between 2005 and 2012 in low-and middle-income countries.
Speaking at its launch in Johannesburg, Steven Allen, regional director for Eastern and Southern Africa at Unicef, said the report presented an opportunity to take stock of what has been achieved in the battle against Aids.
“There has been enthusiasm and emerging evidence in recent months about the possibility of bringing an end to Aids. We are fast approaching a future when all children are born free of HIV and remain so through adolescence. And those who are already infected get the treatment they deserve. As we launch this sixth report we can celebrate many successes,” he said.
Allen cited statistics that showed how infections in infants dropped by more than half in the seven year period from 2005. He believes that this is a result of more resources being made available to mothers living with Aids than before.
“With the right political leadership and parental support, we can meet global targets and succeed in eliminating Aids. What needs to be done is to replicate the South African success story across the continent. However, the challenge remains in the second decade of children’s lives when they reach adolescence.
“Adolescent Aids-related deaths increased by 50% while globally Aids-related deaths fell. However, for the first time in the history of HIV and Aids we have the know-ledge and tools to create an Aids-free generation.”
Remaining focused
One of the reasons for this, said Speciosa Wandira-Kazibwe, the special envoy for HIV and Aids in Africa for the United Nations Secretary-General, is complacency.
“We have been complacent as leaders and have failed to communicate effectively. We are speaking in a language that the current generation of young people who need to hear it cannot understand. How many of us are bloggers, how many of us tweet or are on Facebook? The new generation is active on all these platforms,” she said.
For her, the lessons learnt during the past decade may inform the next 10 years, but the approach needs to change.
“This is the challenge for us as we move forward. We have used the last 10 years to experiment and now we know what we have to do. Now leadership must move forward and do the right thing.” Dr Leslie Bamford, a specialist at the department of health, agreed.
“South Africa has achieved a lot of success, but there are still many mothers who are falling through the cracks. The reasons are numerous and some are related to the mothers themselves.
“However, as a department we are committed to identifying the problems and addressing them.
“But it needs to be a collective effort between ourselves, other public sector departments, the private sector and the people,” she said.
According to Dr Gabriel Anabwani, executive director of the Baylor Children’s Clinical Centre of Excellence in Botswana, all children must have access to HIV treatment.
“By the time they are two months old, children need to be tested, diagnosed and treated effectively.
“Very early testing is absolutely essential. All children who are born in hospital are tested, but those born at home need to be tested as soon as possible so treatment can happen quickly if needs be,” he said.
For Anabwani, HIV is a family disease.
“If a mother comes in and she is HIV-positive, we need to ask if she has children. If a man goes for treatment, people should be able to ask him where his wife and children are, and begin testing and treating them if needed. Simply by doing this, we will be able to reach many more children.”
He also believes that families need to be able to be open to one another in disclosing their status.
“The issue of disclosure is a difficult one especially for mothers or women to their husbands or boyfriends. But one needs to remember that this impacts the life of the child. If their HIV status is not disclosed, then the odds are good that the other parent will also be infected and will not get proper treatment. This will result in the child becoming an orphan.”
Community awareness
The consensus is that HIV awareness has to be community-driven. Training needs to be done to equip teachers with the knowledge they need to effectively help young people who are infected.
Sadly, it seems that fewer leaders are coming forward because international funding is drying up.
The appetite to see HIV and Aids as a priority is no longer there. But funders need to realise that communities cannot deal with the challenge of poverty if HIV is not dealt with.
The UN’s Wandira-Kazibwe cites what happened in Uganda as an example of the need to keep focused on raising awareness.
“In the beginning, Uganda HIV activities were medically driven. It subsequently moved into the social sector and everybody got involved.
“However, we took our foot off the pedal and we missed the opportunity to build on top of the momentum that was initially established. Now we need to look at where we go from here. “We will go back and do what was done really well. It is now a case of how do we mobilise households to make better health decisions. Ultimately, we need to redefine the role of the health system,” she said.
The experts believe that it is now a case of focusing on the solutions and how to get people aware of HIV matters in a short space of time.
But knowledge on its own does not result in behavioural changes in people. Information needs to be packaged in such a way as to drive change. All HIV-related programmes also need to incorporate young men and not just women.
While the issue of finance is important, it is often a case of not needing resources, but being shown how to use them efficiently.
In some cases, the HIV movement has been wasteful. Programmes need to invest funds in places where they will make the biggest impact.
In many instances, complacency about HIV has been a result of the ground-breaking work done.
Complacency now presents an opportunity to raise the response to a new level using experiences from the past. It needs to be a multi-sector approach and not just rely on healthcare to push it forward. All public sector departments need to work together.
For more info about children and Aids and the 6th Stocktaking Report, please visit www.childrenandaids.org
The stats
According to the 2013 Stocktaking Report on Children and Aids, the past 10 years have seen new infections among adults decreasing by more than 50% in Botswana, Ethiopia, Malawi, Namibia, Rwanda, Zambia and Zimbabwe.
In Kenya, Mozambique, South Africa and Swaziland, this figure was more than 25%.
Among children, the number of new infections has dropped from 330 000 in 2001 to 180 000 in 2011.
This is primarily as a result of the national scaling up efforts to eliminate maternal to child transmission by reaching pregnant women living with HIV with essential treatment and services.
The report emphasises that for an Aids-free generation to become a reality, more children living with HIV should receive anti-retroviral treatment. Only 34% of children living with HIV in low- and middle-income
countries received the treatment they needed last year, compared to 64% of adults.
As a result, an estimated 210 000 children died from Aids-related illnesses in 2012.
This article forms part of a supplement paid for by Unicef. Contents and photographs were supplied and signed off by Unicef