Providing paediatric treatment
HIV infection is a major threat to child survival and development in Eastern and Southern Africa, where 47 percent of the world’s HIV-positive children live. Despite political and financial commitments that have resulted in increased access to HIV services in recent years, the annual number of new infections continues to outpace the annual increase in the number of people receiving treatment, and paediatric treatment is particularly lagging behind.
Without treatment, around half of all children born with HIV will die before reaching their second birthday. In 2010, out of the 1.09 million children who needed antiretroviral therapy in ESA, only 29 percent received it. The lack of treatment has a direct effect on overall child mortality rates. In high-burden countries in Southern Africa, such as Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe, HIV contributes to between 10 and 28 percent of all deaths among children under five years of age.
Mortality levels can be reduced dramatically when infants are tested and treated within the first 12 weeks of life. Early infant diagnosis is a crucial step in the continuum of care. If properly diagnosed and then provided with treatment early on, children can survive to adolescence and adulthood.
Despite some significant gains, progress in testing newborns and providing prompt treatment is not ensured equitably within or across countries. Access to antiretroviral treatment is lower among children living in rural areas than among children living in cities. Weak infrastructure and transportation systems, and generally higher levels of poverty, have inhibited achieving equity in these situations. Compared to the general adult population, children are also accessing treatment at lower rates.
UNICEF in action
In partnership with the World Health Organization (WHO), the lead UN agency in the area of paediatric HIV care and treatment, UNICEF provides technical and financial assistance to countries in the region to expand and improve HIV services for children. Increased funding from major donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the US President’s Emergency Plan for AIDS Relief (PEPFAR) and UNITAID, has facilitated this critical support.
To help implement the new 2010 WHO guidelines, which recommend that all children under the age of two who test HIV-positive, should start ARV treatment immediately, UNICEF’s programmes in the region now focus on and advocate for:
To achieve a more effective response, UNICEF also supports the development of guidelines and tools; builds institutional and human resources capacity; and strengthens data collection, analysis and dissemination. The aim is to increase regional coverage of paediatric ART by 2013 to at least 60 percent from a baseline of 32 percent in 2009.
Results for children
While much more needs to be done across the region, there are clear signs of progress:
Children and AIDS
State of the world's children 2012
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