At the London Summit on Family Planning last month a strategy to reduce the further transmission of HIV was discussed, which included the following:
- Integrating family planning, sexual and reproductive health and rights,
- HIV and prevention of mother to child transmission (PMTCT)
- programs to achieve women’s sexual and reproductive health and rights (UNAIDS, 2012b)
This importance of this strategy was reiterated by the head of USAID, Rajiv Shah, at the International Aids Conference in Washington last week where he expressed the importance of health systems and integration within programmes to address issues threatening child well-being and survival as opposed to a focus on single diseases (the Guardian, 2012).
In terms of children and HIV, an integrated approach combining HIV testing and access to treatment within family planning, sexual health and maternal health programmes, has the potential to increase the early detection of HIV in pregnant women and young children, reducing the risk of transmission of HIV from mother to child, thus increasing the likelihood of child survival.
Such a strategy is necessary, despite new infections of HIV amongst children declining by 10% in 2011, on a daily basis around 1,000 children continue to be infected with HIV (the Globe and Mail, 2012). In 2011 an estimated 330,000 babies were infected during childbirth or breastfeeding, despite medications being available to prevent this since the mid 90s and in 2010 approximately 250,000 children aged 15 years or less died of AIDS related causes (UNAIDSa, 2012).
At the Conference Mr Philip O’Brien, Executive Vice-President of the Elizabeth Glaser Paediatric AIDS Foundation asked the pertinent question ‘Have we failed children?’ (the Globe and Mail, 2012). It wouldn’t be too dramatic to say that yes we have, and that the failure is twofold, firstly because HIV continues to be transmitted from mothers to children and secondly because many children living with HIV have no access to treatment.
In answering the question himself, Mr O’Brien stated, ‘If not a failure, the least you can say is that we have a lot of work left to do’, and indeed we do. Despite the cost of antiretroviral drugs dropping from around $10,000 to $200 in the space of 16 years (the Economist, 2012), only an estimated one in four children living with HIV receives treatment worldwide. The majority of these children will die before the age of two if they don’t receive treatment due to their underdeveloped immune systems (the Globe and Mail, 2012).
The resources exist as does a collective desire to bring about change, however Mr O’Brien states that it is connecting the dots between identifying those who need these resources and actually getting them to them that is the challenge (the Globe and Mail, 2012). A more integral approach to women’s health and its links to that of their children could help to achieve this, contributing to the strong progress made to date, potentially surpass the UNAIDS Global Plan, target 1 to “reduce the number of new childhood HIV infections by 90%”.
The Economist, Aim for victory, July 28-August 3 2012
The Global and Mail, ‘We have a lot of work left to do’: Child AIDS advocate, 27 July 2012, http://www.theglobeandmail.com/life/health-and-fitness/health/we-have-a-lot-of-work-left-to-do-child-aids-advocate/article4446468/
Global Fund, Summit on family planning stresses on linkages with HIV services, 17 July 2012, http://www.zero-hiv.dreamhosters.com/summit-on-family-planning-stresses-on-linkages-with-hiv-services/
The Guardian, Rajiv Shah of USAID sees the way ahead on Aids and global health - but where is Europe?, Sarah Boseley’s blog, 30.07.2012, http://www.guardian.co.uk/society/sarah-boseley-global-health/2012/jul/30/hiv-infection-obama-administration