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Children and Aids

The Third Stocktaking Report on Children and AIDS, released on World Aids Day 2008, shows some promising trends in meeting the needs of women and children living with HIV, particularly across Africa. With a nod to strong political commitment and leadership, strong funding commitments, enabling policies and the adoption of innovations in service delivery, the strongest results show up in the prevention of mother-to-child-transmission of HIV.

Children are the missing face of Aids
Sub-Saharan Africa (SSA), where about 70% of the total number of people living with HIV (UNAIDS 2007) live, is the most affected region by the HIV epidemics. Close to 85% of all pregnant women living with HIV (UNAIDS 2007) live in SSA.

The 24 countries of West and Central Africa is the second hardest hit by the AIDS epidemic,with one third of the global burden of HIV/AIDS. There is a disparity in prevalence from one country to another, ranging from 6.3% in Central African Republic to less than 1% in Mauritania and Niger.

The region has the world’s lowest social and human development indicators, other factors that could fuel the epidemics include the predominance of armed conflict and post-conflict situations, gender based sexual violence, persistence of population migration increasing number of child trafficking and child prostitution, rapid urbanization, high youth unemployment rates, environmental degradation and extreme poverty.

A rapid feminization of the epidemic is observed in WCAR.  Young women aged 15-24 years have three times the HIV prevalence rates of young men in the same age group, respectively 7% and 2.3% in 2007. One quarter of the world’s women living with AIDS is from West and Central Africa.

Consequently, children pay the tribute of the epidemics. An estimated 650,000 children (0-14 years old) are infected in West and Central Africa, nearly 1/4 of the world’s children 0-14 years old living with HIV.

More than 20 million children have been orphaned, among whom 3 million representing one fourth of the total of number of orphans who have lost one or both parents due to AIDS. National proportions of children who become orphaned due to AIDS range from 39% in Central African Republic, 33% in Cote-d’Ivoire to 4% in Niger. 

P1: Preventing mother-to-child transmission (PMTCT)
There is a progressive increase in the coverage of PMTCT services in the region. The uptake of antiretroviral prophylaxis for PMTCT increased from 2% in 2004 to 11 % regionaly in 2007. Several countries developed PMTCT scale-up plans. A review of national PMTCT guidelines in order to introduce more efficacious antiretoviral (ARV) prophylactic regimens for women who are not eligible for antiretroviral therapy has been conducted in 11 countries. 

Individual countries made significant progress in 2007 namely Benin: 40%, Gambia 26%; Cameroun: 22%, Sierra Leone, Gabon and Ghana: 21%.

A small but increasing number of women are getting screened for diagnosis and treatment. This Third Stocktaking Report since the Unite for Children,Unite against AIDS initiative was launched in 2005,examines data on progress, emerging evidence, and current knowledge and practice for children as they relate to four programme areas known as the ‘Four Ps’: preventing mother-to-child transmission of HIV, providing paediatric HIV care and treatment, preventing infection among adolescents and young people, and protecting and supporting children affected by HIV and AIDS.

P2: Providing paediatric treatment and care
A sensible progress is observed in the region on pediatric AIDS treatment, especially in Burkina Faso, Benin and Cameroun. The number of HIV infected children under age 15 who received anti-retroviral treatment increased in the region from 4,000 in 2005, 11,000 in 2006 to 26,000 in 2007.

Cotrimoxazole preventive therapy coverage is still very low in the region. UNITAID project is operational in 3 countries: Cote d’Ivoire, Cameroun and Burkina-Faso where significant improvements are foreseen in the strengthening of the health system. Two additional countries, Nigeria and Central Africa Republic will be initiating their planning process.

Despite progress, countries contributing to the largest share of pediatric infections are currently lagging behind (Nigeria: 7%, DRC: 9%, Côte d’Ivoire: 12%, Chad: 1%)

P3: Preventing infection among adolescents and young people
By the end of 2007, 16 out of 24 countries in the region are implementing programs addressing risk factors. UNICEF works with young people throughout the region to develop appropriate educational materials, establish anti-AIDS youth clubs and train AIDS peer educators. By the end of 2007, life skills-based education has been incorporated into the national curricula of 16 countries in West and Central Africa.

UNICEF’s role has been especially important for out-of-school children and adolescents and for finding ways to reach them, such as putting up information booths in marketplaces and identifying key places to share information in the community.  Strategies on risk mapping and targeting the most at risk and vulnerable adolescents are under development in Cameroun, Congo, the Democratic republic of the Congo and the Central African Republic.

As a result, comprehensive knowledge on HIV prevention among young people 15-24 years old has increased, reaching 21% Nigeria, 34% in Cameroun, 44% in Ghana, 57% in Togo and 67% in Senegal.

UNICEF also works to strengthen the capacity of health services to provide treatment for sexually transmitted disease, HIV counseling and testing and the management of sexual abuse, including rape of women and girls.

UNICEF endeavors to ensure that conflict, fragile and post-conflict countries include HIV/AIDS and gender violence programs in their response plan.

P4: Protecting and Supporting Children Affected by AIDS
Children affected by AIDS programming continues to be chronically under-funded and lagging behind countries' competing priorities. Limited efforts to promote more context-specific orphans and vulerable children (OVC) programming for the region did not allow countries to better and appropriately address the OVC vulnerability to HIV. UNICEF and other partners developped a regional strategic framework for OVC programming in low prevalence settings.

A number of countries such as the Democratic Republic of the Congo (DRC), Burkina-Faso, Sierra-Leone and Côte d’Ivoire are showing good national-level leadership among partners. For example in DRC, beneficiaries from the support programme were 30,331 in 2006 and are 51,533 in 2007, and 37% of identified children affected by AIDS have been integrated into primary school at no cost to their families. In Burkina Faso, 47,225 children affected by AIDS and their families benefited from a package of services including food, school supplies and health care. In addition, there is an increasing national leadership for children affected by AIDS.





Children and Aids

Third Stocktaking Report
full report [PDF 2MB]
summary [PDF 2.3MB]


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