UNICEF, UNAIDS, WHO and UNFPA have published the Fifth Stocktaking Report on Children and AIDS. Progress is being made. Thanks to improved evidence and advocacy, children have become central to national HIV and AIDS strategies. But there is still work to be done:

• More than 1000 babies continue to be born each day with HIV; many of whom will die before their second birthday unless they receive medication.
• Many mothers are still dying.
• Adolescents are still becoming infected with HIV owing to lack of knowledge and access to services.

Progress

• The goal of virtual elimination of mother to child transmission of HIV by 2015 appears within reach. In 2005, for example, 15% of HIV positive pregnant women in low-to-middle income countries received ARVs for PMTCT; in 2009 this had increased to 53%.
• In 2005, 5,2 million young people were HIV positive; this has dropped to 5 million today.
• Before 2005, children who had lost both parents to AIDS were far less likely to go to school; today they are almost equally likely to be in school.

Moving forward

In moving forward there is a need to address the emerging “second generation” issues to assure quality, coverage and equity and to drive the demand for services that will lead to universal access for children.

Success in moving forward depends on advocating successfully for a holistic approach that builds on maternal and newborn platforms:

• The maternal and child health systems must function and must offer effective follow-up services for HIV- infected pregnant women and their babies.
• Transport costs must be addressed as this is one of the biggest barriers preventing parents from getting their children to clinics for follow-ups.
• Families must have access to financial and other support to be able to buy and grow food to keep their children healthy.
• Health care workers must be motivated to integrate and link services into the full health service spectrum.
• Social and structural drivers of HIV must be addressed alongside biomedical interventions to have a lasting impact on prevention.
• Sustainable life-long care and treatment mechanisms for children must be found.
• Obstacles preventing TB-HIV co-infection among children and their families must be addressed.
• Young people must be engaged in the fight against AIDS.

All efforts must be shaped by equity. All interventions must ensure universal access for those most hard to reach.

WEB LINKS FOR THIS ARTICLE

Children and AIDS Fifth Stocktaking Report, 2010