Info Service on Health Issues (January 07/04)
More children with HIV but more getting treatment
some 15.2 million children under 18 have lost one or both parents to
AIDS. By 2010, more than 20 million children will have been orphaned
by AIDS. The figures reflect the ‘tragically insufficient’ global response
to protect and support HIV-infected and AIDS-affected children. However,
this is set to change according to a report by UNICEF, the UN children’s
article below is reproduced with the permission of South-North Development
Monitor (SUNS) #6172, 19 January 2007.
Health: More children
with HIV, but also more getting treatment
By Mithre J Sandrasagra,
IPS, New York, 17 January 2007
The world's response to protect
and support HIV-infected and AIDS-affected children remains "tragically
insufficient", but that is beginning to change, according to a
new report by the UN children's agency UNICEF.
The "Unite for Children, Unite Against AIDS" initiative was
launched in October 2005 by UNICEF with the goal of putting the "missing
face" of children at the centre of the global HIV/AIDS agenda.
This week's report, titled "Children and AIDS: A Stocktaking Report",
evaluates the world's response to protect and support AIDS-affected
children in the year since the initiative began.
"One year ago we did not know how many children were on treatment,
we did not know how many governments were spending money on children,
and we couldn't say with any certainty how many services children orphaned
or otherwise were getting," Peter McDermott, who runs UNICEF's
AIDS programme, told reporters at the launch of the report.
"Most countries did not count children," McDermott explained.
He stressed that one year on, UNICEF has established baseline data with
cooperation from governments.
And the agency has identified some positive trends. "Over the past
year, there has been a broad, growing recognition of the need to intensify
and accelerate actions towards universal access to comprehensive prevention,
treatment, care and support," according to the report.
Commitment to this goal by 2010 was affirmed by heads of state and government
and their representatives participating in the 2006 High-Level Meeting
on AIDS held at the UN last June.
Glimmers of hope have been seen in preventing HIV transmission from
mothers to children. In several countries in Eastern and Southern Africa,
trends in access to antiretroviral regimens for preventing mother-to-child
transmission are starting to show remarkable increases.
In Namibia, for example, access rates jumped from 6% to 29% from 2004
Increasing numbers of children living with HIV are now receiving treatment,
although the numbers are far too few. The increases are a result of
improved testing, better skills among health workers, lower drug prices
and simpler formulations, according to the report.
Two years ago, UNICEF was concerned that a number of factors stopped
children from getting treatment. One was the ability of health workers
to identify infected children. Another was whether the available drugs
were safe for children and affordable in poor countries, McDermott said.
Prices have now declined and the drugs have been proven safe when administered
to children, he continued.
There are however, huge gaps in progress.
Globally, as of 2005, an estimated 15.2 million children under 18 have
lost one or both parents to AIDS; about 80% of these children live in
sub-Saharan Africa. By 2010, more than 20 million children will have
been orphaned by AIDS.
In addition to these orphans, many more children are left vulnerable
by AIDS, including those who live with parents who are chronically ill,
those who live in households that have taken in AIDS orphans, or those
who have lost teachers and other adult members of the community to the
Orphans and other children affected by AIDS face grave risks to their
education, health and well-being.
Children who have lost both parents - to AIDS or any other cause - are
generally less likely than non-orphans to attend school, according to
To counter this threat, at least 20 countries in sub-Saharan Africa
have completed national plans of action (NPA) on orphans and vulnerable
children, and several others have nearly completed and launched their
In South Africa, the country with the largest number of orphans due
to AIDS, more than 7.1 million children under 14 living in poverty were
benefiting from a government child support grant by April 2006. Botswana
and Namibia also provide child grants and other benefits to children
affected by AIDS.
Of the 2.3 million children under 15 living with HIV, an estimated 780,000
were in need of antiretroviral treatment (ART) in 2005. Just 10% of
children in need of ART have access to it, according to the report.
Those not receiving ART face a bleak and short-lived future. An estimated
one-third of infected infants die in their first year, and half die
by their second birthday, according to UN statistics. In 2006, an estimated
380,000 children died of AIDS-related causes; the vast majority of these
deaths could have been prevented either by treating opportunistic infections
or providing ART.
Only seven countries identified in the report provided ART to at least
20% of children needing it. They are Botswana (84%), Cape Verde (47%),
the Dominican Republic (23%), Jamaica (47%), Namibia (52%), Rwanda (20%)
and Thailand (95%). These countries are "on target", according
One out of 10 pregnant women living in the capital cities of sub-Saharan
Africa is infected with HIV and about one in three children born to
HIV-positive mothers will contract the virus.
The highest known infection rates among pregnant women are in Gaborone,
Botswana and Mbabane, Swaziland, where one in three is infected, and
in Maseru, Lesotho and Pretoria, South Africa, where one in four is
"Barriers to care are poor transportation for families and lack
of disclosure within families of infection," said Heidi Schwarzwald,
vice president of Clinical Affairs for the Baylor International Pediatric
AIDS Initiative, who just returned after spending eight months in Botswana.
Another persistent problem identified at the launch was the overwhelming
lack of data for some regions.
"Even in large countries like Brazil, key data are not available
for children," Marie-Pierre Poirier, UNICEF representative in Brazil,
told reporters. "Countries must put children at the center of their
national responses," Poirier stressed.
The report emphasises that the Millennium Development Goals (MDGs) -
especially MDG 6, which is to halt and reverse the spread of HIV/AIDS,
malaria and other diseases by 2015 - will not be reached without integrating
approaches to children and AIDS with approaches to child health and
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