Agenda 3: Updated gap analysis on pædiatric HIV treatment, care and support
By Jeffry Acaba
The NGO Delegation appreciates the UNAIDS Secretariat, in collaboration with partners, for the updated gap analysis on pædiatric HIV treatment, care and support.
The doubling of the number of children below age 14 being enrolled into ART from 2011 to 2016 shows good progress, and we would like to recognize the concerted efforts that have been made by the Joint Programme, as well as the commitment from the Member States, in preventing unnecessary and totally preventable deaths of children living with HIV.
We also welcome the Super Fast-track Framework: an ambitious goal to eliminate new HIV infections among children below the age of 14 or to enroll them into treatment upon diagnosis, and making it sure that they retain into care. An important aspect of this is ensuring that we are reaching out to children in this age spectrum through a differentiated approach. This has worked well with PEPFAR, preventing nearly 2 million babies being born with HIV, supporting 1.1 million children into treatment, and 6.2 million orphans and vulnerable children from the impact of HIV and AIDS. Fast-tracking this super fast-track even further requires moving our efforts around diagnosing infants early and making sure that they and their mothers will not get lost to follow up.
Combining the Super Fast-track Framework with the All In to End Adolescent AIDS Strategy can help us bridge that difficult transition gap from childhood into adolescence, as we prepare them into adulthood. But are these enough? In Indonesia, young mothers living with HIV who use drugs still face challenges in accessing prenatal and antenatal care due to their drug use, which hinders them from enrolling into care. In Hongkong, many adolescents sex workers find it difficult to access HIV testing and treatment because of fear of discrimination and the lack of a legal framework that would allow them to access much-needed services despite their age. I would like to emphasize that as we recognize the Start-Free, Stay Free, AIDS Free Framework, people who have sex are getting younger and younger, hence we need comprehensive sexuality education and that we should not leave children, adolescents, and young people of and within key populations behind.
Whether it is “Super-Fast Track” or “All-In”, this vehicle will not run smoothly without a “Keep Safe” component into it: that component that will protect children, adolescents, and young people living with HIV and other key populations from stigma and discrimination as we close the gap in accessing HIV services along the HIV cascade. And in this resource-limited situation that we are facing, we need more evidence and analysis on the experiences of, and ways to eliminate stigma and discrimination among these groups.
My network, Youth LEAD, has recently developed a leadership training course that gives older children and adolescents living with HIV a space to discuss how they can protect each other and help each other when they are discriminated. I was in Nepal and in one conversation with a 13-year old boy living with HIV, he asked me, “are you positive too”? I said yes and asked, “why?” And he told me, “I wish I can live long enough to reach your age so that I can help younger people like me face their fears too.” Let us make his aspiration come true. Let us protect him from discrimination. We need all hands on deck, and that includes those of children, adolescents, and young people living with HIV and from key populations, to guide the Joint Programme and the countries with a clear sense of direction on how we can keep our children free from HIV and AIDS. Some of these children will be filling up this very room twenty years from now, and they might thank us for keeping them HIV-free, for protecting them from violence and discrimination, and for keeping them alive all these years.