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Remarks by Anthony Lake, UNICEF Executive Director at the Center for Strategic and International Studies in Washington DC

Washington, DC. 22 July 2012

Thank you, Steve, for that warm welcome and for hosting us once again at the Center for Strategic and International Studies.   And thank you all for joining us.

There is no more fundamental nor important challenge than giving every child the chance to survive and thrive.  It is the right of every child, everywhere … The dream of every mother and father…  And the abiding hope of human society. 

Today, we have the ability to realize that right … to achieve that dream … and to fulfill that hope.  This is not just rhetoric.   Eliminating mother to child transmission is possible. Let me repeat: it can be done.  The science is certain, the benefits are clear.

And if we are successful -- as we must be – we will be much closer to achieving an AIDS-free generation … and to ending this epidemic, which has caused so much suffering, at such an unconscionable cost, over the past three decades.

As we discussed here in April with representatives from your nations, the path is clear – but the going will not be easy.

Earlier this week, we learned that between 2001 and 2011, the number of children newly infected with HIV in low and middle-income countries declined by more than 40 per cent – from 550,000 new infections in 2001 to 330,000 in 2011.  That is 220,000 tragedies averted last year alone, compared to 2001 … a big number when properly measured as the stories of 220,000 individual lives.   

This is a remarkable achievement, and it took your leadership and commitment to tackle a problem that once seemed insurmountable … and to make solving that problem a priority. 

 It has taken global partnership, to support your efforts and to make antiretroviral medicines more affordable, more available, and easier for mothers and infants to tolerate.

 It has taken thousands of doctors, nurses, community health workers and people living with HIV themselves, all working together.

 It has taken courage on the part of millions of women and men to defy a risk of stigma and be tested, and to follow through with treatment.

 And now it will take all of that – and more – to meet the 2015 target date of the Global Plan to reduce the number of children newly infected with HIV by 90% from 2009. 

It’s an ambitious goal, but with so much at stake – the lives of millions of children, the well being of millions of families … the strength of their societies – how can we be anything less than persistently, intensely ambitious?  And relentless.

That means we must all work to become ever more efficient, more effective, and more innovative: in our policies … in our products … and in our practices.  And it will take all of us working together to simplify HIV treatment and integrate it with basic antenatal and primary health care.

That is why we are so encouraged in supporting the efforts of countries to implement the B and B+ protocols. 

Unlike the most common protocol today – Option A, which protects only babies from HIV – Options B and B+ are designed both to prevent the transmission of HIV from mother to child and to preserve the health of HIV positive mothers … so that they can live longer, healthier lives and watch their children grow and thrive.  The B and B+ protocols also protect HIV-negative partners against sexual transmission, further strengthening families and saving lives.   And the ability to use the same single pill, once-daily regimen for all adults, including pregnant women, is a major step forward – simplifying procurement … streamlining supply chain management … and, most important, making it easier for people living with HIV to adhere to their medication.

Think of it: A protocol designed to be so simple that nurses – not just doctors – can prescribe it to pregnant women following a rapid HIV test and diagnosis at the primary level of care.  This is an important advance -- shifting tasks to nurses and thus expanding the reach of community-based health care. 

A protocol designed to make it easier to follow for women living far from health clinics … thus enabling us to reach more women, more babies, and more families.  Wherever they are.  Whatever their circumstances.  We could call it the equity protocol.

Momentum is building for this new approach, and for good reason.  As you will hear later, Options B and B+ -- and the single pill approach -- are not only sound medical practice.  Over time, Option B – and, we hope, Option B+, which extends treatment beyond the breast feeding stage throughout a woman’s life -- may also result in significant cost savings. That is the conclusion of new modeling, conducted by the Business Leadership Council and UNICEF in close collaboration with the Clinton Health Access Initiative and in consultation with the World Health Organization. 

To be clear: There is no single solution – no silver bullet -- to achieving our goal of an AIDS-free generation.  But we believe Options B and B+ can accelerate our progress.  And we are committed to supporting the efforts of national governments which wish to adopt these protocols to meet their own unique needs. 

This is a pivotal moment.   We have virtually eliminated mother to child transmission of HIV in the world’s wealthy nations.   We must do no less in the world’s poorest countries.  This could be a giant step towards an AIDS-free generation -- the beginning of the end of AIDS.

Now, when we are closing in on success, we must work together more closely than ever before.  For as the old proverb says, many sticks in a bundle cannot be broken.   

 So now, let me introduce my sister, friend, and mentor – and my co-chair today: Dr. Margaret Chan, Director-General of the World Health Organization.  I know I always agree with what she says, so I especially look forward to hearing what that is. 





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