Are we moving towards an Aids-free generation?

Reza Hossaini
On November 29, UNICEF released a new report documenting the progress the world has made in combating HIV.
The Children and AIDS Stocktaking Report for 2013 shows that significant progress has been made in reducing the number of children born with HIV but much more attention is needed to prevent and treat HIV in adolescents.
The world is on the cusp of completely wiping out mother-to-child transmission of HIV, raising the tantalising prospect of an entire generation of babies born free of HIV.

Between 2005 and 2012, 850 000 babies born to mothers who were HIV positive in low and middle income countries tested negative for HIV.

Where a few years ago, a baby born to an HIV positive mother was almost certain to acquire the virus, advances in medical science and the scaling up of prevention programmes have made it possible for such babies to be born free of HIV.

An AIDS-free generation means a generation in which all children are born free of HIV and remain so for the first two decades of life, from birth through adolescence.

It also means that children living with and affected by HIV have access to the treatment, care and support they need to remain alive and well.

Globally, great progress has been made to prevent mother-to-child transmission of HIV.
Since the first effective ARV regimen to prevent mother-to-child transmission of HIV was reported in 1994, the chances of babies not contracting the virus from their mothers have lengthened tremendously.

In high income countries, mother-to-child transmission of HIV has virtually been eliminated. Today, we have great hope that countries like Zimbabwe are on a similar path.

But this will require expanding coverage of the most effective ARVs and exploring new approaches of providing these drugs, especially to the most marginalised women.

A major step in this direction was the launch of Option B+ by the Vice-President Joice Mujuru on November 13, 2013. This means all pregnant women who are diagnosed with HIV will immediately be placed on antiretroviral treatment regardless of their immunity level. And they will remain on treatment for the rest of their lives. This move will not only reduce the risk of HIV being passed on to the baby, it will also improve the health of the mother and prolong her life. While progress is being made for children in the first decade of life, the story is different for adolescents.

The report shows that global AIDS-related deaths amongst adolescents between the ages of 10 and 19 rose from 71 000 in 2005 to 110 000 in 2012. The survival prospects for the 2,1 million adolescents living with HIV remain bleak. For the most part, this is a generation that was infected through their mothers a decade or so ago.

Something urgent needs to be done. We need to see more children living with HIV placed on antiretroviral treatment.
Reza Hossaini is UNICEF Representative in Zimbabwe

The global figures make for depressing reading, only 34 per cent of eligible children in low and middle income countries are accessing ARVs compared with 64 per cent of adults.

Zimbabwe fares only better, with 45 per cent of children accessing treatment compared with 68 per cent of adults. When the full AIDS story is written by generations to come, it will show that the journey towards an AIDS-free generation began in the mother’s womb.
For, even if a pregnant woman is living with HIV, it doesn’t mean her baby will automatically be infected with the virus. The facts bear this out: new infections among babies are on the decline, even in countries where the burden of HIV is high. Notice the 58 per cent decline in Namibia, 55 per cent in Zimbabwe, 52 per cent in Malawi and Botswana, and 50 per cent in Zambia. The arc is dipping and it’s dipping in our favour.

What is left now is for us to strongly commit to sustaining the hard-won gains and to address the unacceptable inequities in access to treatment that consign children and adolescents to an untimely death. Keeping the first and second generation free from HIV will lead to an HIV-free adult generation.

Reza Hossaini is UNICEF Representative in Zimbabwe