Children’s Turning Point: Creating an AIDS-Free Generation

NS40 years from First AIDS case reportedThe harsh reality is that deep inequality continues to exist in the global response to HIV and AIDS, and the gap between rights and services is hampering actual progress.

It’s hard to admit, but one of the most overlooked segments of the population is children.

As “End inequality, end AIDS” The strategy proposed by the Joint United Nations Program on HIV / AIDS (UNAIDS) clarifies that “one of the most obvious disparities in HIV control is not meeting the needs of children living with or at risk of HIV.” I am.

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NS Final progress report NS “Start for free, for free, for AIDS” An initiative that has just been released by our organization, UNAIDS (BW), and Elizabeth Glaser Pediatric AIDS Foundation (CL) and partners are scrutinizing HIV and children. Currently, about 1.7 million children live with HIV. Nearly 2,000 people die each week and 5,900 new children and adolescents are infected with the virus. Only 54% of children living with HIV can receive life-saving treatment. Children accounted for only 5% of people living with HIV in 2020, but they accounted for 15% of all AIDS-related deaths. Almost 90% Of all the children living with HIV around the world, they live in Africa.

If there is no voice in the response, children have an unequal opportunity to seek solutions to their needs. Covid-19 has Further strengthening Existing inequalityDivert funds and other resources from critical medical services.

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But even before Covid-19 took root, the situation was awkward.New childhood HIV infection On an upward trend In a handful of African countries, the coverage of pediatric treatment has been stalled, and the global community has been unable to identify and reach nearly half of the children living with HIV. None of the “Start Free, Stay Free, AIDS Free” goals set in 2020 have been achieved, and in fact, have not been significantly achieved.

World leaders gathered in June United Nations High Level Meeting on HIV and AIDS To show the future direction of global AIDS countermeasures. As leaders of organizations working to eradicate HIV and AIDS, we were encouraged to include a new global pledge as a result. Political declaration Eliminate mother-to-child HIV transmission and end childhood AIDS by 2025.

Commitment is meaningless without action. As global, national, and community leaders move to develop behavioral frameworks, we focus on four key areas to drive momentum to achieve the first AIDS-free generation. And call on them to strengthen their commitment to children in a realistic and meaningful way.

Find the children. Improving efforts to “find” and diagnose children of all ages living with HIV is an essential gateway to increasing the number of children accessing the drug and ensuring viral load control.Effectiveness of Point of Care Early Infant Diagnosis Is a well-documented game changer, but the adoption and scale-up of this strategy is at a standstill and needs to be scaled up in countries around the world.

Help your children receive life-saving treatment. Without treatment, one in two babies infected with HIV Die before 2nd birthday.. Children living with HIV need age-appropriate, effective, and readily available prescriptions.Still, children in low- and middle-income countries Often wait for years They can access the same medications as adults, harm their health, and even lead to preventable death. The development and dissemination of optimal, child-friendly HIV treatments has fallen far behind such studies in adults, deteriorating the health of the youngest patients. Recent UNAIDS The data show that 800,000 children living with HIV went without medication in 2020 and are deeply concerned about the reversal of recent progress. There is an urgent need for a rapid transition to better pediatric formulations in combination with improved HIV diagnosis for children.

Focus on prevention. The rate of mother-to-child transmission of HIV Cut in half The last 10 years.But its success Stagnant In a nasty way.HIV testing to end mother-to-child transmission Adolescent girl and young woman This includes prevention of unintended pregnancies and enhanced primary prevention efforts for both pregnant and lactating women— Including pre-exposure prophylaxis (PrEP) — ​​When the global community is moving forward Biden’s call “Regaining government-wide focus on lifting women and girls around the world.”

Address women’s structural barriers at the community level. Various socio-economic and structural factors such as unequal power dynamics and gender norms, gender-based violence, poverty, stigma, and discrimination have led many women to access and engage in clinical services and psychosocial support. It weakens the ability to continue. Women’s needs must be at the heart of every effort. Stakeholders need to be aware of obstacles to medication compliance or consistent clinic visits and address them with improved options and community-level support.

To end children’s AIDS, governments, civil society and other stakeholders must follow up on political declarations and act urgently with concrete actions that are in line with their aspirations. This means providing resources and services to protect the unique rights, needs and perspectives of children and young women, and doing so with a clear focus on human rights and equity.

Ending childhood AIDS is ambitious and achievable. Let’s make 2021 another turning point in the history of AIDS eradication. And in the process, let’s create the first generation without AIDS.

Winnie Byanima is the Secretary-General of UNAIDS and the Deputy Secretary-General of the United Nations. Chip Lyons is the CEO of the Elizabeth Glaser Pediatric AIDS Foundation.