UNICEF warns, the global HIV response is failing children and adolescents
Children and adolescents in sub-Saharan Africa need to be urgently prioritised otherwise HIV targets will not be met.
Unless the HIV response is stepped up, we will not end AIDS in children and adolescents. This is the stark message in a new UNICEF report, released earlier this month.
18 children are newly infected with HIV every hour according to the 2017 UNICEF Statistical Update on Children and AIDS. In 2016, 120,000 children under the age of 14 died from AIDS-related causes and there are now 2.1 million adolescents living with HIV across the world.
“It is unacceptable that we continue to see so many children dying from AIDS and so little progress made to protect adolescents from new HIV infections,” said Dr. Chewe Luo, Chief of HIV for UNICEF. “The AIDS epidemic is not over; it remains a threat to the lives of children and young people and more can and should be done to prevent it.”
However, progress has been made elsewhere. Major advances in services to reduce mother-to-child transmission (also referred to as ‘vertical transmission’) are one success story. In 2016, three quarters of all pregnant women living with HIV accessed treatment to improve their own health and reduce the risk of their baby acquiring HIV. Since 2010, 1.6 million new infections in children have been averted.
Yet, much more must be done if services are to reach all the children who need them. Many HIV infections among infants remain undiagnosed. In 2016, only 43% of infants who had been exposed to HIV were tested within their first two months of life and 57% of all children known to be living with HIV were not receiving the lifesaving treatment they need.
Children in certain regions are particularly vulnerable. 38% of new infections in children occurred in West and Central Africa, yet only 49% of pregnant women living with HIV in the region receive the antiretroviral treatment they need.
The future looks even worse for older children. AIDS-related deaths among younger children have halved since 2010, but for adolescents (aged 10-19) the mortality rate has decreased by just 5%. UNICEF predicts, if current trends continue, there will be 3.5 million new adolescent infections by 2030.
Girls in sub-Saharan Africa are at the highest risk of all. For every five adolescent boys living with HIV there are seven girls. Among older adolescents (aged 15-19 years), three in four new infections occur in sub-Saharan Africa.
In 2016, a framework was developed to end AIDS in children, adolescents and young women, with super fast-track targets set for 2020. According to UNICEF we will fail to meet these targets unless much more is done.
The report calls for immediate action to accelerate the HIV response including:
- interventions targeted at those who are most at risk
- the scale up of treatment and services for children and adolescents living with HIV
- investment in new technologies including self-testing and pre-exposure prophylaxis (PrEP)
- better data collection.
Dr Luo is clear, “to continue at this slow rate of progress is to gamble with the lives of children and commit future generations to a preventable life of HIV and AIDS.”