“Despite the progress made in reducing HIV cases and AIDS-related deaths among children”, to free them from the disease by 2030 “it is urgent to expand HIV services in the countries most affected by the pandemic”. The appeal comes with the report ‘Transforming Vision Into Reality’ by UNICEF and the Global Alliance to End AIDS in Children by 2023 (launched in 2022 by the UN agency for children and the World Health Organization). The report shows that in 2023, globally, approximately 120,000 under 14s were infected by the AIDS virus and 76,000 died, of which 49,000 in the 12 countries of the Global Alliance.
The report says that programmes aimed at interrupting vertical (mother-to-child) transmission of HIV have prevented 4 million HIV cases in children aged 0-14 since 2000. Globally, new HIV-positive cases under 14 have decreased by 38% since 2015 and AIDS-related deaths have fallen by 43%. Among the countries of the Global Alliance, many have achieved strong lifetime antiretroviral therapy coverage among pregnant and breastfeeding women living with HIV: Uganda almost 100%, the United Republic of Tanzania 98%, South Africa 97%; Mozambique has achieved 90% coverage, like Zambia, Angola and Kenya 89%, Zimbabwe 88% and Côte d’Ivoire 84%.
“Countries of the Global Alliance – notes UNICEF in a note – are innovating to overcome barriers and accelerate progress towards ending AIDS in children. However, despite progress, neither the world nor the countries of the Global Alliance are currently on track to meet HIV commitments for children and adolescents, and the pace of progress in preventing new HIV cases and AIDS-related deaths among children has slowed in recent years”. In addition, “vertical transmission rates remain extremely high in some locations, particularly in West and Central Africa, exceeding 20 per cent in countries such as Nigeria and the Democratic Republic of the Congo”. And “it is worrying that the treatment gap between adults and children continues to widen”.
Only 57% receive treatment compared to 77% of adults
“Only 57 per cent of children living with HIV receive life-saving treatment, compared to 77 per cent of adults,” said Anurita Bains, UNICEF Associate Director for HIV/AIDS. “Without early and effective testing and treatment, HIV remains a persistent threat to the health and well-being of children and adolescents, putting them at risk of death. To close the treatment gap, we must support governments to scale up innovative testing approaches and ensure that children and adolescents living with HIV receive the treatment and support they need.”
The report then highlights a ‘female issue’. In 2023, there were 210,000 new HIV cases globally among girls and women aged 15 to 24 (130,000 in the countries of the Global Alliance), 4 times higher than the 2025 target of 50,000. “Preventing new infections in this age group is essential, both to protect the health and well-being of young women and to reduce the risk of new cases among children,” warns UNICEF.
“Gender inequalities and human rights violations – the agency points out – are increasing women’s vulnerability to HIV and reducing their ability to access basic services. Globally, nearly 1 in 3 women has experienced some form of violence during her lifetime, and adolescent girls and young women are disproportionately affected by intimate partner violence. In the four countries of the Global Alliance with available data, they are not currently on track to meet the target of ensuring that by 2025, fewer than 10% of women, key populations and people living with HIV experience gender inequalities and gender-based violence”.
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