by Eliane Drakopoulos – Elizabeth Glaser Pediatric Foundation
EGPAF welcomes the release by UNAIDS of this report on the strategic use of ARVs, but notes with disappointment the lack of emphasis on children living with HIV. There are key gaps in the report when it comes to looking at the impact of HIV on children, and how to ensure their access to treatment. These are lost opportunities. For while there has recently, finally, been increasing recognition that children are being left behind in the HIV response—including in this report and during the recent ICASA conference in South Africa—there are still precious few concrete recommendations and strategies being put forward as to how to tackle this problem.
Simply saying that we must do better to ensure treatment for children living with HIV is not enough.
While we work toward our common goal of ending pediatric HIV, we cannot neglect the need to find and care for those falling through the cracks – whose mothers were missed, lost, or later infected. We must study and determine what the specific barriers to such treatment are, and dismantle them, one by one.
Countries like Zimbabwe, Swaziland, Rwanda, Namibia and Botswana are making great strides in scaling up PMTCT programs, identifying and treating children, and we must continue to support them in these efforts and study what they are doing right so that it can be replicated in other countries, as appropriate and relevant. But countries like Nigeria, the DRC, Angola and Cameroon are not doing as well. These countries can and MUST do better to ensure that their children are not excluded from the gains we are making in ensuring HIV prevention and treatment for those who need it, and we must all give them our support to do this.
The lives of thousands of children depend on it. Half of children born with HIV who do not receive treatment will die by their first birthdays – 80 percent will be dead before they reach the age of three. This is not just an issue of access, it is a matter of human rights, and one that must be addressed with urgency.
It is not only young children at risk here. Adolescents are dying at unprecedented rates. Our efforts to reach children must extend to those vulnerable young people who so often fall between the cracks, and in many cases don’t even realize they are infected.
EGPAF asks UNAIDS, its co-sponsors and PCB Member States to redouble their efforts to identify the specific reasons for the gross disparity in access to HIV treatment by children versus adults, and to develop a strategic plan to tackle the barriers creating this disparity so that we can work towards ensuring that in the near future, ALL children who require HIV treatment are able to access it. EGPAF stands at the ready to cooperate in this endeavor in every way it can.
It is only through a rigorous identification of the problems, and joint creative thinking about solutions—including through the strategic use of ARVs—that we can finally achieve a generation of children free of AIDS. Ending the transmission of HIV to children through PMTCT programmes is a great step – and we have made huge strides in this area. But we must not forget the 700 children still born with HIV day after day after day. These children deserve a healthy future that they can only have by accessing treatment — and it is up to us to do the hard work to ensure that they get it.