Last update: April 2008

Provide Paediatric Treatment

The Challenge

An estimated 2.1 million [1.9–2.4 million] children were living with HIV in 2007, while 420,000 children [350,000–540,000] were newly infected, mainly through mother-to-child transmission of HIV. Because the virus progresses rapidly in children, treatment is vital to infected children’s survival; without treatment, half of all infants who are infected will die before age two. In 2007, an estimated 290,000 children [270,000–320,000] died of largely preventable AIDS-related causes. The vast majority of these deaths were preventable, either through treating opportunistic infections with antibiotics or through antiretroviral treatment (ART).

Nearly 90 per cent of children infected with HIV live in sub-Saharan Africa, illustrating the need for antiretroviral treatment in Africa.

Progress

MDG Indicator

Percentage of children 0–14 years old with advanced HIV infection receiving antiretroviral therapy

Significant advances have been made in scaling-up paediatric ART in the past few years, particularly in 2006. As of December 2006, 127,300 children were being treated up from 75,000 in December 2005—an increase of 70 per cent. In the two most affected regions, Eastern and Southern Africa and West and Central Africa, paediatric treatment coverage increased 72 and 170 per cent, respectively. In all regions increases in coverage of over 50 per cent were seen and many more children received the necessary treatment.

Significant progress is being made in sub-Saharan Africa where the majority of all children (Aged 0–14) in need of antiretroviral therapy live; but all other regions are also making progress

Source: UNICEF global databases, 2005–2006.

Fortunately with price cuts on antiretrovirals (ARVs), introduction of fixed–dose ARV combinations, better forecasting of paediatric ARV drugs and increased advocacy, more countries are able to provide ARVs for children, thus, leading to the increased number of HIV-positive children receiving these life-saving drugs.

Of the countries that have the largest numbers of children in need of treatment in the world, so far only four—Brazil, Botswana, Namibia and Thailand—have reached coverage levels of at least 50 per cent of children in need of treatment. Nevertheless, momentum is building in several other countries toward reaching Universal Access by 2010.

Challenges, however, still exist. Most countries have low PMTCT uptake, including limited follow-up testing of HIV-exposed infants, lack of access to early diagnosis and cotrimoxazole preventive treatment. The inability of many health-care systems to track children’s HIV status even when mothers are known to be infected with HIV results in many missed opportunities. Because treatment for children is often provided in a clinic other than the one in which the mother received antenatal care or delivered her infant, children exposed to HIV often go unrecognized when they visit immunization clinics and other care-delivery points.

References

Expanded Inter-Agency Task Team (IATT) on Prevention of HIV Infection in Pregnant Women, Mothers and their Children, A Report Card on Prevention of Mother-to-Child Transmission of HIV and Paediatric HIV Care and Treatment in Low- and Middle-Income Countries: Scaling up Progress from 2004—2005, 2007.

UNAIDS and WHO, Aids Epidemic Update, Geneva, 2007.

UNICEF, Progress for Children: A World Fit for Children Statistical Review, No. 6, New York, 2007.

UNICEF, UNAIDS and WHO, Children and AIDS: Second Stocktaking Report, New York, 2008.

UNICEF, UNAIDS and WHO, Children and AIDS: A Stocktaking Report, New York, 2006.

WHO, UNICEF and UNAIDS, Towards Universal Access: Scaling up HIV Treatment, Care and Prevention Interventions in the Health Sector (forthcoming).

WHO, UNICEF and UNAIDS, Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector, Geneva, 2007.