Among the 22 Global Plan priority countries, only two were providing EID for more than 80 per cent of infants in need in 2012: South Africa (85 per cent) and Swaziland (81 per cent). They were followed by Namibia (74 per cent), Lesotho (69 per cent52) and Zambia (61 per cent). Coverage of EID is less than 10 per cent in five of the priority countries: Angola, Chad, the Democratic Republic of the Congo, Malawi and Nigeria.53 In low- and middle-income countries, the vast majority of children diagnosed with HIV do not begin ART in a timely manner; in 2012, only 34 per cent of children under 15 years diagnosed with HIV received treatment. As a result, an estimated 210,000 (190,000–250,000) children died from AIDS-related illnesses that year.54
Special attention is needed to ensure that women have access to ARVs and are retained in care during the breastfeeding period Breastfeeding is critical for child survival and growth. WHO recommends that mothers living with HIV who are taking ART and breastfeeding should exclusively
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TOWARDS AN AIDS-FREE GENERATION – Children and AIDS: Sixth Stocktaking Report, 2013
Current service delivery models rely heavily on the provision of paediatric HIV treatment at specialized paediatric HIV clinics or adult HIV clinics, whereas task shifting or task sharing with health-care workers other than medical doctors – to facilitate care to decentralized levels, including through community-based services – should be a priority to improve access.55
While global data on ARV coverage during the breastfeeding period are limited, it is estimated that, in 2012, nearly half of mothers in the 21 Global Plan priority countries in Africa did not receive ARVs during the breastfeeding period. Up to about half of all new infections in children in sub-Saharan Africa are estimated to have occurred as a result.57 Special attention is therefore needed in all countries to ensure access to, and retention on, ART for breastfeeding mothers.
Primary prevention needs for women and family planning services for women living with HIV remain inadequate Provision of ARVs to pregnant women and mothers living with HIV to prevent mother-to-child transmission (identified as Prong 3 of PMTCT in the Global Plan) and of treatment of mothers and children living with HIV for their own health (Prong 4) has been substantial. However, progress in primary
Progress on reducing new HIV infections among children has been faster than ever before. But to meet the 2015 target, the pace of progress will have to accelerate.
850,000
new HIV infections among children (0–14 years) in lowand middle-income countries were prevented between 2005 and 2012.
14
breastfeed their infants for the first six months of life, introducing appropriate complementary foods thereafter, while continuing to breastfeed until the child is 12 months old. Breastfeeding should then stop only when a nutritionally adequate and safe diet without breast milk can be provided. Infants of mothers who are receiving ART and breastfeeding should receive 6 to 12 weeks of infant prophylaxis with daily nevirapine. Alternatives exist for women living with HIV who do not breastfeed.56
39%
Only of children in low- and middle-income countries were estimated to have access to HIV testing within the recommended 2 months of birth in 2012.