UNICEF in action: Strategy and priorities
For far too long, children have been the missing face of the HIV epidemic.
In an effort to draw attention to the impact of HIV and AIDS on children, UNICEF, UNAIDS and other partners in 2005 launched the global campaign Unite for Children, Unite against AIDS. The campaign builds on the Millennium Declaration and its Millennium Development Goals (MDG) as well as on other promises world leaders have made since the UN General Assembly Special Session on HIV/AIDS in 2001 (UNGASS).
Through Unite for Children, Unite against AIDS, UNICEF has provided programmatic leadership and advocacy to ensure that children and adolescents are put at the centre of the HIV/AIDS agenda.
The campaign triggered global attention to the impact of HIV and AIDS on children and led to important additional funding being allocated to related programmes. Since its launch, the evidence base around children and AIDS has improved tremendously. Based on the increased knowledge, UNICEF and partners have developed new guidelines and programmes in order to strengthen the quality of services and to reach those which are still excluded.
In 2010, the World Health Organization (WHO) issued new guidelines according to which all children under the age of two who are tested HIV-positive, shall start antiretroviral therapy (ART) immediately. All other patients living with HIV are eligible for treatment when their CD4 count of helper cells falls below 350 per microliter, up from 200. Mothers living with HIV should exclusively breastfeed their infants for the first six months and continue to breastfeed up to 12 months while introducing complementary foods in country settings where breastfeeding is the safest infant feeding option. Breastfeeding needs to be accompanied by ARV treatment.
UNICEF is supporting the implementation of the new WHO guidelines throughout Eastern and Southern Africa (ESA). Building on the lessons learned over the past years, UNICEF programmes now focus on and advocate for:
Goals and targets
PMTCT and providing paediatric treatment
Thanks to such innovations and strong donor commitment, achieving an HIV-free generation has become possible. UNICEF in 2009 endorsed the UNAIDS call for ‘virtual elimination of mother-to-child transmission of HIV by 2015’, which aims a) at ensuring that less than 5 percent of children born to women with HIV are themselves positive in order to b) to reduce the number of new infections among young children by 90 percent compared to 2009. To achieve this goal, UNICEF agreed to reach two concrete goals in Eastern and Southern Africa:
Among the region’s 21 countries, nine account for 90 percent of the estimated 860,000 pregnant women living with HIV in 2009 and seven more than 90 percent of the 1.08 million children estimated to be in need of ART in 2010 (South Africa, Mozambique, Uganda, Tanzania, Kenya, Zambia and Zimbabwe). The HIV prevalence rate (2009) in these countries ranges from 0.1 percent in Comoros to 23.6 percent in Lesotho and 25.9 percent in Swaziland, with prevalence rates between 2 and 4 percent in Angola, Rwanda and Burundi; 5 to 10 percent in Kenya, Tanzania, and Uganda, and between 10 and 18 percent in Malawi, Mozambique, Namibia, South Africa, Zambia and Zimbabwe.
Prevention among young people
UNICEF supports the global UNAIDS goal of reducing new infections among young people aged 15 to 24 years by 30 percent by 2015.
As part of these efforts, UNICEF increasingly focuses on reducing the risks and vulnerabilities of adolescent girls. These include behaviour change communication components that promote increasing comprehensive knowledge, increasing HIV counselling and testing, promoting consistent condom use, and reducing age disparate sex, as well as multiple and concurrent sexual partners.
In the context of the global UNAIDS goal, UNICEF has established a regional goal of ensuring that by the end of 2013, 80 percent of adolescent girls aged 15 to 19 years, in 11 countries, practice behaviours which reduce their risk of HIV infection. To achieve this goal, UNICEF has identified four key results to be achieved by 2013 in 11 priority countries:
Protection for vulnerable children
In order to strengthen support for orphaned and vulnerable children, UNICEF will work to enable the development of coherent social protection systems at the country level.
In the region, UNICEF has established a 2013 goal of supporting 10 countries to develop national child and social protection systems that are child- and HIV-sensitive with a focus on the most vulnerable families, contributing to universal access and the achievement of the MDGs. To achieve this goal, UNICEF will support country progammes to:
Children and AIDS
Unite for Children Unite Against AIDS