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Experts gather to discuss status of National Strategic Plan targets for children

UNICEF/South Africa/2009/Pawelczyk
© UNICEF/South Africa/2009/Pawelczyk
UNICEF Representative Aida Girma with senior Government officials and members of the Children's Sector at the Durban AIDS conference

South Africa has stepped up efforts to meet targets, but many challenges remain says UNICEF

Durban ... UNICEF joined the Children’s Sector of the HIV/AIDS National Network in hosting a satellite session at the National AIDS conference in Durban, to look at the progress being made in reaching targets set for children in the National Strategic Plan (NSP).

Two years after the adoption of the Plan for which ambitious, but realistic targets for children were set, an expert panel comprising children’s health, protection, education and HIV experts, came together in Durban to discuss the theme “Progress towards achieving the targets for children in South Africa’s National Strategic Plan:  Where are we and what are our next priorities.”

In a two-hour panel discussion chaired Aida Girma, UNICEF South Africa Country Representative and Cati Vawda, Director of the Children’s Rights Centre and Children’s Sector Representative on SANAC, the experts set out to review implementation progress and build consensus on priority interventions and actions to accelerate the achievements of the NSP targets for children.  In separate presentations, they also identified successes and operational bottlenecks in the implementation of HIV prevention, care, support and treatment programmes for children, including adolescents.

Focus limited HIV and AIDS resources on what has been proven to work
“Making the NSP work is a responsibility for all of us,” said Professor Helen Rees in her opening presentation. Professor Rees who co-chairs the South African National AIDS Council (SANAC) Programme Implementation Committee and chairs of the SANAC Research Sector Prevention Sub-Committee stressed that we must focus on interventions for which there is strong supporting evidence, such as programmes for circumcision for young adolescent boys and newborns and comprehensive prevention of mother-to-child transmission of HIV (PMTCT) programme.   She also called for continued provision of social grants to those who need them – especially the Child Support Grant to children up to 18 as this will help decrease vulnerability of young girls.  Another important strategy for preventing the spread of HIV, according to Prof. Rees, is the promotion of girls education.  

We are not on track to meet NSP targets for children
“Every time you are less than perfect there are women and children falling through the system,” said Dr. Ashraf Coovadia, Head, Paediatric HIV and PMTCT services, Rahima Moosa Mother and Child Hospital, Johannesburg, and Children’s Sector Representative on SANAC. “The evidence suggests that we are not quite on track to meet both the prevention and treatment targets of the NSP, he said. Dr. Coovadia acknowledged that shortcomings have a multiplier effect and translate into thousands of women and children not being served. He proposed an examination of the public-private healthcare interface to ensure that women and children do not fall through the cracks. In concluding, Dr. Coovadia proposed several actions for accelerating PMTCT and Paediatric HIV and ADS care and treatment, including the intensification of social mobilization to increase PMTCT uptake; the scaling up of early infant diagnostic of HIV;  the improvement of  data quality;  the review of guidelines and training, and the revision of the NSP  targets.

UNICEF/South Africa/2009/Pawelczyk
© UNICEF/South Africa/2009/Pawelczyk
UNICEF Representative Aida Girma with senior Government officials and members of the Children's Sector at the Durban AIDS conference.

Following the presentations, panelists were joined by senior government officials from the National Departments of Health, Education and Social Development who took questions from the floor. Dr. Yogan Pillay of the National Department of Health, said that governments and civil society needed to agree on the social determinants of health. Many medical problems are based in the social circumstances, he said. He proposed strengthening of health facilities which would increase demand for services and focusing on district-based response to HIV and AIDS. 

Through the Millennium Development Goals MDGs), countries like South Africa have committed to reducing under-five mortality by two-thirds by 2015. According to the latest report by UNAIDS, there are an estimated 300,000 children between 0-14 years living with HIV and AIDS in South Africa and close to 1.5 million children have lost one or both parents to AIDS. 

The joint 2007 UNICEF/ MRC/Department of Health and Save the Children report, Every Death Counts, Saving the lives Mothers, Babies and Children in South Africa, says AIDS accounts for about 35 per cent of all under-five deaths and that AIDS related mortality in children has shown to be highest in the first two years of life. Thirty-five per cent of children infected die before their first birthday, and 52 percent of infected children before their second.   

 “South Africa has stepped up its efforts to respond to the impact of the epidemic on children, but there are still major bottlenecks to the realization of the NSP targets for children. The Mid Term Review of the NSP is an opportunity to rethink national strategies for scaling up response for children with a view to focus on proven interventions and taking the fight against HIV and AIDS down to communities. UNICEF will continue to work closely with the Government, the Children’s Sector and other partners in supporting national efforts to scale up response for children” said Ms Girma.

UNICEF South Africa co-hosted the satellite session with the Children’s Sector HIV/AIDS National Network a civil society network of networks, organizations and people working on issues relating to children and HIV/AIDS. The group was extensively involved in the development of the NSP and monitors ongoing progress for children. Members also represent the children’s sector on the South African National HIV/AIDS Council.

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