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While global targets for 2018 are not met, the Start Without, Stay Free, Without AIDS report shows that efforts need to be focused on lagging countries
GENEVA / MEXICO, July 22, 2019-A new report released today at the 10th IAS conference on HIV Sciences in Mexico City, Mexico, shows that the world is lagging behind in its commitment to end the world of HIV. AIDS epidemic in children and adolescents. The report, Start free, stay free, without AIDS, shows that the pace of progress in reducing new HIV infections in children and expanding access to treatment for children, adolescents and pregnant women living with HIV has slowed significantly and that the global targets set for 2018 have been missed, despite significant progress in some areas. countries.
Globally, about 160,000 children aged 0 to 14 years were newly infected with HIV in 2018. This represents a significant decrease from the 240,000 new infections reported in 2010. However The bold and important goal set for 2018 was less than 40,000 new infections.
"The inability to reach the 2018 targets to reduce new HIV infections in children and adolescents and expand access to life-saving treatments is both disappointing and frustrating," said Gunilla Carlsson, executive director of UNAIDS, said "We must act quickly to remedy this situation and honor the commitment made to end the AIDS epidemic for the next generation."
About 82% of pregnant women living with HIV now have access to antiretroviral drugs. Considerable progress has been made in countries of eastern and southern Africa, with more than 90% of pregnant women having access to antiretroviral drugs in Ethiopia, Kenya, Uganda, the United Republic of Tanzania, and Zimbabwe. 95% or more in Botswana, Malawi, Mozambique and Namibia. and Zambia. This resulted in a 41% reduction in new HIV infections among children, with notable reductions in Botswana (85%), Rwanda (83%), Malawi (76%), Namibia (71%), Zimbabwe (69%) and Zimbabwe. Uganda (65%) since 2010. The progress made by these countries shows what can be achieved through strong political leadership, early adoption of the policy and the concerted efforts of all stakeholders.
The report highlights areas where gaps need to be filled to prevent new HIV infections in children. For example, in East Africa, 10,000 of the 26,000 new HIV infections among children in 2018 were due to the fact that women had not been on treatment throughout pregnancy and badfeeding . In southern Africa, 17,000 of the 53,000 new infections in children result from HIV infection of the mother during pregnancy or badfeeding. A total of 16,000 new infections could have been prevented in southern Africa by keeping mothers on treatment throughout pregnancy and badfeeding. In West and Central Africa, nearly 27,000 of the 44,000 new infections could have been prevented if their mothers had access to antiretroviral drugs.
"This new evidence shows that many countries have made significant progress in meeting the 2020 targets, while others are lagging far behind," said Deborah Birx, Global AIDS Coordinator for the United States. Special Representative for Global Health Diplomacy. "These glaring disparities highlight the crucial role of political commitment, rapid implementation of policies and data-driven investments to accelerate impact."
Country-level badysis of how HIV transmission from mother to child occurs can provide vital information for shaping national responses.
"Ending AIDS and achieving universal health coverage means leaving no one behind. Yet, too many HIV-positive children and adolescents still do not have the chance to grow up healthy because they do not have access to treatment, "said Ren Minghui, Deputy Director. General of the World Health Organization / Universal Health Coverage / Communicable and Noncommunicable Diseases "We must intensify our efforts and keep our promise to these children."
Children living with HIV are also left behind in the expansion of HIV treatment and are not diagnosed and treated early enough. An estimated 940,000 children aged 0-14 years had access to treatment in 2018, double the number of patients on treatment in 2010, but well below the target of 1.6 million set for 2018.
Children living with HIV are even less likely to have access to treatment than adults living with HIV, a disparity that is growing in some countries, particularly in West and Central Africa. As a result, the AIDS epidemic still kills many children aged 0 to 14 years. Children in this age group accounted for 5% of all people living with HIV in 23 target countries, but accounted for 15% of those who died of AIDS-related illness in these countries in 2018.
"We know how to prevent children from contracting HIV and prevent the onset of AIDS in children who are infected, they need to be tested and linked to care and treatment urgently, but we miss Henrietta Fore, Executive Director of the United Nations Children's Fund, said: "It's not enough to know what to do. We need to come together and act with a renewed commitment to children and adolescents living with HIV and give them the best chance of survival. and prosper. "
For optimal outcomes, HIV-infected children need access to treatment as quickly as possible. However, by 2018, only 63% of the 1.1 million HIV-exposed infants in the 23 most-affected countries had been tested for HIV before the age of two months.
"In many ways, our community has opted for poor quality of care for children living with HIV," said Chip Lyons, President and CEO of the Elizabeth Glaser Pediatric AIDS Foundation, "We must not allow children to receive perpetually less than the basic care we require for adults. Especially when the ultimate consequence of this approach is that children and young people die of HIV at disproportionate and unacceptable rates. "
The report also shows that it is unlikely that the goal of reducing the annual number of new HIV infections among young women and girls aged 15 to 24 years to under 100,000. by 2020 is reached. Globally, the number of new HIV infections among young women and girls decreased by 25% between 2010 and 2018 to 310,000. While new HIV infections among teenagers and young people women aged 15 to 24 have decreased by more than 40% in Botswana and Burundi Lesotho and South Africa, the lack of a global target has left 6,000 adolescent girls and young women still infected with HIV each week.
The factors underlying the vulnerability of young women and girls to HIV infection are of a social, structural and behavioral nature and must be taken into account in order to achieve sustainable prevention results. Gender discrimination, gender-based violence, limited access to opportunities and the lack of appropriate services exacerbate their vulnerability to HIV. Effective responses prioritize an approach that combines access to HIV and badual and reproductive health services with social, structural and behavioral programs.
"The disparity between viral load suppression rates in HIV-positive adolescents and adults is unacceptable and is prompting the global community to advocate for stronger and more potent antiretroviral regimens for adolescents and to accelerate prevention efforts." new infections in this extremely vulnerable population, "said Fatima Tsiouris, deputy director of the Clinical and Clinical Training Unit and responsible for the prevention of mother-to-child transmission at ICAP of the US. Columbia University.
The number of male voluntary medical circumcisions performed between 2015 and 2018 is over 11 million in all age groups, which means that at least 13 million procedures must be completed by 2020 to achieve the goal of voluntary circumcision of 25 million men and women. boys between 2015 and 2020.
UNAIDS and the US President's Emergency Plan for AIDS Relief launched the "Start Free, Stay Free and AIDS Free" framework in 2016 to build on the achievements of the United States. Global plan to eliminate new HIV infections among children by 2015 and keep their mothers alive, which ended in 2014.
UNAIDS
The Joint United Nations Program on HIV / AIDS (UNAIDS) guides and inspires the world to realize its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS brings together the efforts of 11 UN organizations – UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank – and works closely with global and national partners to end The AIDS epidemic by 2030 is an integral part of the Sustainable Development Goals. Learn more about unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.
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