U.N. Says PMTCT of HIV Is Achievable, Efforts Must Target Millions Currently "Falling Through the Cracks"

"A generation of babies could be born free of AIDS if the international community stepped up efforts to provide universal access to HIV prevention, treatment and social protection, the United Nations said on Tuesday," Reuters reports. The declaration came on the eve of World AIDS Day, as U.N. leaders released a new report (.pdf), which found "millions of women and children, particularly in poor countries, fall through the cracks of HIV services either due to their gender, social or economic status, location or education," according to the news service (Kelland, 11/30).

"To achieve an AIDS-free generation we need to do more to reach the hardest hit communities," UNICEF Executive Director Anthony Lake said in New York at the launch of the report, which was a collaboration between UNICEF, UNAIDS, UNESCO, UNFPA and WHO, U.N. News Centre writes. The U.N. has called for the virtual elimination of mother-to-child transmission of HIV by 2015, the news service notes (11/30).

The report documents the impact of efforts to prevent mother to child transmission (PMTCT) of HIV and provide treatments to children living with HIV/AIDS: "In 2005, only 15 percent of HIV-positive pregnant women in low- and middle-income countries received antiretrovirals for the prevention of mother-to-child transmission (PMTCT) of HIV; in 2009, 53 percent of women in need received antiretrovirals for PMTCT," the report states. "In 2005, only 75,000 children under 15 in need received antiretroviral treatment. Today, that figure is approximately 356,400, around 28 percent of those in need."

The report also notes that "for every problem solved or advance made, new challenges and constraints have arisen. PMTCT services are established -- but they are not fully utilized. Progress has been made towards targets -- but it has been inequitable. More children are diagnosed with HIV early in their lives -- but their test results may not be picked up, they may not be enrolled in treatment, and many of them are likely to die" (2010).

"Although it is very rare for a child to be born with HIV in the developed world, there are still a thousand newborns a day infected in Africa," UNICEF's head of HIV and AIDS Jimmy Kolker said, according to Reuters. "According to the latest United Nations data, 370,000 children were born with HIV in 2009, the vast majority of them in Africa -- the region that bears by far the highest AIDS burden," Reuters writes. HIV/AIDS also remains "one of the leading causes of death worldwide among women of reproductive age and a major cause of maternal death in countries with AIDS epidemics. In sub-Saharan Africa, nine percent of maternal deaths are attributable to HIV and AIDS, UNICEF said," according to the news service (11/30).

U.N. News Centre notes that the WHO recently revised its guidelines to improve PMTCT services for pregnant women living with HIV/AIDS and their infants, as well as new antiretorival guidelines for infants and children, "paving the way for many more children with HIV to be eligible for immediate antiretroviral therapy (ART)" (11/30).

"Even where early infant diagnosis is available and is offered to many thousands of children, the cascade, the number who do not end up, if the test is positive, getting on medication, which would be life saving, a remarkable impact on young children," Kolker said, VOA News reports. "But, the majority of kids in the countries we studied did not actually access the medication, even though the test results did show they were positive," he added (Schlein, 11/30).

The Guardian notes that HIV/AIDS prevention and treatment programs for mothers and infants vary "between and within countries" in terms of "the numbers who are reached."

"Throughout southern Africa, services are being scaled up, but we need to pay attention to those who are being missed," Kolker said. "Also, the demand question is key. How do you empower people to take advantage of the services which do exist in their country?" The article details UNICEF's efforts to provide HIV testing and, if necessary, mother-baby packs of treatment, to pregnant women during their "first -- and sometimes ... only -- antenatal check" (Boseley, 11/30).

"We have strong evidence that elimination of mother-to-child transmission is achievable," WHO Director-General Margaret Chan said, according to U.N. News Centre. "Achieving the goal will require much better prevention among women and mothers in the first place," she added. The news service notes women remain at a disproportionate risk of HIV infection. "[I]n many countries women face their greatest risk of infection before age 25. Worldwide, more than 60 percent of all young people living with HIV are female. In sub-Saharan Africa, that figure is nearly 70 percent," U.N. News Centre writes (11/30).

In a "statement before World AIDS Day ... the UNAIDS director Michel Sidibe said: 'Nothing gives me more hope than knowing that an AIDS-free generation is possible in our lifetime,'" Reuters reports (11/30).

This information was reprinted from kff.org with permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives, and sign up for email delivery. © Henry J. Kaiser Family Foundation. All rights reserved.