TOWARDS AN AIDS-FREE GENERATION – Children and AIDS: Sixth Stocktaking Report, 2013
© UNICEF Malawi/2013/Marinovich
© UNICEF/NYHQ2012-1507/Jayasuriya
More progress has been made between 2009 and 2012 than during the previous decade, according to 2012 data, which show a 35 per cent decline in new HIV infections among children under the age of 15 years, compared with 2009.2 In 2012, coverage of antiretroviral drugs (ARVs) for pregnant women living with HIV reached 62 per cent in the 22 priority countries in the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (the ‘Global Plan’).3 Yet, approximately 230,000 (180,000–300,000) children – or 630 (540–760) per day – were newly infected with HIV in these countries during 2012.4 While the world is currently reducing new HIV infections among children faster than at any other time in history, the pace will have to be accelerated even more to achieve the Global Plan 2015 target.
Ensuring the health of pregnant and breastfeeding women living with HIV is central to achieving an AIDS-free generation In the past three years, countries have begun moving towards early initiation of triple-drug regimens and simplified programming for eliminating mother-to-child transmission of HIV. This approach emphasizes the long-term health of pregnant and breastfeeding women living with HIV as well as the prevention of HIV infection among their children. The World Health Organization’s 2013 Consolidated Guidelines on
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© UNICEF/ZIMA2011-00003/Pirozzi
the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection recommend initiating antiretroviral therapy (ART), either lifelong or during the mother-to-child transmission risk period, for all pregnant and breastfeeding women living with HIV. All children under 5 years of age diagnosed with HIV should also be provided with lifelong ART, regardless of their CD4 count.5 The move to providing ART for all pregnant and breastfeeding women represents an important paradigm shift that places women’s health and well-being at the centre of preventing HIV in children. Keeping mothers alive and healthy is one of the most important factors for early child survival. Preventing HIV infection among women and girls of childbearing age and helping women and girls who are living with HIV to avoid unwanted pregnancies remain priorities towards preventing HIV infections among children.
More children are accessing ART, but progress for children lags behind progress for adults Overall, ART coverage for children under 15 years old living with HIV in low- and middle-income countries has consistently been around half that for adults – 34 per cent of children in 2012 compared with 64 per cent of adults in 2012.6 Children under 15 years old who need ART to survive are significantly less likely than adults to receive it. In the