UN reports progress in ending mother-infant HIV transmission but urges more action

Although some countries have achieved breakthroughs in preventing HIV transmission from mothers to children and providing treatment for children living with HIV/AIDS, an “unconscionably” low percentage of pregnant women with HIV are receiving the necessary treatment, the United Nations Children’s Fund (UNICEF) said today.

In a report entitled “Children and AIDS: A Stocktaking” released to mark the one-year anniversary of the launch by UNICEF and its partners of the “Unite for Children, Unite against AIDS” campaign, the agency stressed the paramount urgency of preventing HIV transmission from mothers to children and keeping mothers free from HIV/AIDS.

An estimated 530,000 children under 15 were newly infected with HIV in 2006, mainly through mother-to-child transmission. Without treatment, 50 per cent will die before age two.

“There is an urgent need to help children impacted by HIV/AIDS,” UNICEF Executive Director Ann M. Veneman said. “Unite for Children, Unite against AIDS is focused on ensuring treatment for HIV-positive children, prevention of mother-to-child transmission and assisting children who have been orphaned by AIDS. We must build momentum to achieve positive results for children.”

The stocktaking report finds signs of considerable progress with some high-prevalence countries in Eastern and Southern Africa achieving breakthroughs in preventing mother-to-child transmission.

In Namibia, the percentage of HIV-infected pregnant women who received antiretrovirals (ARVs) to prevent transmission increased from 6 per cent in 2004 to 29 per cent in 2005. In South Africa the percentage increased from 22 per cent in 2004 to 30 per cent in 2005.

But despite these gains, it is estimated that only 9 per cent of pregnant women with HIV in low- and middle-income countries in 2005 were receiving ARVs to prevent transmission, an increase from 3 per cent in 2003.

The report notes particular momentum in treating children living with HIV/AIDS, a result of improved testing, better health worker skills, lower drug prices and simpler formulations. Several countries, including Botswana, India, Rwanda, South Africa and Thailand, have been able to scale up HIV treatment of children by integrating it into treatment sites for adults.

Globally, only one in 10 children needing antiretroviral treatment receives it. Only 4 per cent of children born to HIV-infected mothers receive prophylactic treatment to prevent opportunistic infections that can be fatal.

Prices of ARV drugs for children have come down dramatically over the past 12 to 18 months. The Clinton Foundation HIV/AIDS Initiative negotiated a reduction in the cost of paediatric ARVs to less than $0.16 per day, or $60 per year, helping to spur competition in the development of paediatric formulations.

The report notes that prevention responses are focussing strategies on adolescents and young people most at risk. This group includes young women; globally, a higher number of young women are being infected than men. In Côte d’Ivoire and Kenya, for example, there are five infected young women for every infected young man.

New evidence suggests that declining HIV prevalence in Kenya, urban areas of Côte d’Ivoire, Malawi and Zimbabwe, and in rural areas of Botswana, has resulted from the adoption of safer sexual behaviour by young people. In more than 70 countries surveyed, testing and use of counselling services increased from roughly 4 million people in 2001 to 16.5 million in 2005.