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Stepping towards an AIDS-free generation

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HIV report on children, mothers, Women’s health and well-being has been placed at the centre of preventing HIV in children.

For the first time in the history of the HIV epidemic, the global community has accumulated the knowledge, experience and tools to achieve an AIDS-free generation, according to a new report from UNICEF.

The report defines ‘AIDS-free generation’ as ‘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 – and in the report the term ‘children’ applies to all children below the age of 18 years – living with and affected by HIV have access to the treatment, care and support they need to remain alive and well.’

The report, ‘Towards an AIDS-Free Generation – Children and AIDS: Sixth Stocktaking Report, 2013’, focuses on the response to HIV and AIDS among children in low- and middle-income countries, and says that more progress in treating HIV was made between 2009 and 2012 than during the previous decade; 2012 data show a 35 per cent decline in new HIV infections among children under the age of 15 years, compared with 2009.

And it says that 2012 also saw coverage of antiretroviral drugs (ARVs) for pregnant women living with HIV reach 62 per cent in the 22 priority countries in the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (the ‘Global Plan’).

The move to providing antiretroviral therapy (ART) for all pregnant and breastfeeding women has been a major change.

Keeping mothers alive and healthy has been recognised as one of the most important factors for early child survival, and has meant that women’s health and well-being has been placed at the centre of preventing HIV in children.

Nonetheless, at the end of 2012 approximately 2.1 million (1.7 million–2.8 million) adolescents were living with HIV globally, and approximately two thirds of new HIV infected adolescents aged 15–19 years were girls.

Actually preventing HIV infection among women and girls of childbearing age and helping women and girls who are living with HIV to avoid unwanted pregnancies are still  priorities when it comes to preventing HIV infections among children. Figures show that in the absence of HIV testing and timely ART initiation, one third of infants living with HIV die before their first birthday, and more than half die before the age of 2 years.

This report highlights both the gains and the gaps in the response to HIV among children in the first and second decades of their lives, and while it emphasises high-prevalence settings, there is also still concern for children in lower-prevalence settings – and the clear challenge is to maintain and expand upon progress made.

And unfortunately, creating an AIDS-free generation is more than a biomedical endeavour.

Economic and social drivers of HIV – such as poverty, food insecurity, drug and alcohol use, social marginalization, gender inequality, violence and sexual exploitation, and the lack of access to education, including comprehensive sexuality education – also need to be addressed.

But at least now, it this report is anything to go by, the path to an AIDS-free generation is clear.

An AIDS-free generation, the report emphasises, is possible, but it  will only be achieved through strong leadership from government, determined support of common objectives and the wholehearted participation of civil society and affected communities.

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