Press Conference on UNICEF’s ‘Children and AIDS - Fourth Stocktaking Report’

An AIDS-free generation was now in sight, but progress around the world had been extremely uneven, marked by huge deficiencies in preventing transmission of the disease, said Jimmy Kolker, Chief of the United Nations Children’s Fund (UNICEF) HIV and AIDS Section, as he presented a new joint report on the impacts of the pandemic on children at a Headquarters press conference today.

The report, entitled Children and AIDS: Fourth Stocktaking Report 2009, was issued by the Joint United Nations Programme on HIV/AIDS (UNAIDS), UNICEF, United Nations Population Fund (UNFPA) and the World Health Organization, on the eve of World AIDS Day, 1 December 2009.

Among its conclusions, children were now higher on the global AIDS agenda and practitioners were using evidence to save lives, Mr. Kolker said.  Between 2007 and 2008 alone, there had been a 40 per cent increase in paediatric treatment numbers. Prevention of Mother-To-Child Transmission of HIV (PMTCT) coverage was now at 45 per cent, versus only 10 per cent coverage four years ago, when the “Unite for Children, Unite against AIDS” campaign was launched.  Where there were integrated services and a strong commitment, uptake of those services was high.

However, he said, prevention was especially low among young girls, and children orphaned by HIV/AIDS were not getting the help they needed. Nigeria had surpassed South Africa as the country with the most HIV-positive pregnant women, and today represented 30 per cent of the unmet need for services to prevent transmission to newborns.  Generally, families and caregivers provided models for the types of social protections needed in response to the global economic crisis. The report highlighted various examples of such initiatives, which had to be AIDS-sensitive and able to help all children.

Joining Mr. Kolker were panellists C. Virginia Fields, President of the National Black Leadership Commission on AIDS; Bertil Lindblad, Director of the UNAIDS New York Office; Nathan Shaffer, World Health Organization (WHO) Senior Advisor on Prevention of Mother-To-Child Transmission of HIV; Reshma Pattni, Programme Director, Global Youth Coalition on HIV/AIDS; and Prateek Awasthi of the Youth Participation programme at the United Nations Population Fund (UNFPA).

Taking the floor next, Ms. Fields said the Commission was the oldest, largest non-profit organization in the United States that worked with Government, the private sector and clergy to fight HIV/AIDS in local communities.  It also had partnered with UNAIDS to examine the impact of HIV/AIDS on children, and this year, would work with the United States mission to the United Nations.  In the 10 years since the first call to action, progress had been made and lessons learned. There were now clear signals for how to stem the tide of HIV/AIDS.

To that point, Mr. Lindblad cautioned that “we’re still not there”.  The call for universal access to comprehensive prevention programmes, treatment, care and support had been made in 2006, in a political declaration.  Efforts had to be sustained and scaled-up, and it was critical that financing continue. HIV/AIDS had most severely impacted sub-Saharan Africa, where 91 per cent of all new infections among children occurred.  Some 14 million children had been orphaned, which underlined the importance of social protections. On the upside, new data showed that 40 per cent of young people now had basic information on HIV.  It was time to recommit to the struggle.  “It is not over,” he said.

Speaking next, Mr. Shaffer said 2009 marked a critical year for progress in combating mother-to-child transmission, and efforts must now centre on how well that progress took root.  With that in mind, WHO was revising guidelines on treatment and protection, prevention of mother-to-child transmission, and infant feeding and HIV/AIDS.  A key aspect to the guidelines emphasized the need for mothers to be put on treatment for their own health and for the threshold of those eligible to be increased to 40 per cent.  Also, temporary treatment should be provided during breastfeeding, which would ensure that more children were HIV-free.  Taken with other measures, the guidelines provided an opportunity to move towards eliminating paediatric AIDS.

Until that time, Ms. Pattni pointed out, over half of all new infections occurred in people under age 25.  Her organization offered e-courses that empowered young people to become activists and a network of focal points to inform young people about such opportunities.  Youth needed “correct and complete” knowledge to prevent transmission. They were not a homogenous group. In planning policies and programmes, it was imperative to reach out to those most at risk and, in that context, she underlined the need for data disaggregated by age and sex.

Rounding out the panel, Mr. Awasthi said progress in prevention had been slow. HIV/AIDS would not be halted unless services were made available to those most at risk. Comprehensive sexual and reproductive services had to reach young pregnant women and continue through post-pregnancy.  Young people were important to finding solutions and their buy-in was critical to the success of any programme.

Taking a question on how she was working with the United States Government, Ms. Fields said the Commission was sharing information on its efforts to engage clergy, media and organizational leaders.  Through its 12 affiliates and volunteer staff, the Commission was also reaching out to health officials, providing counselling and referral services, and promoting comprehensive health education in schools, with a focus on the role of parents in providing that education.

Asked for an overview of the HIV/AIDS situation in the Middle East, Mr. Kolker said the main challenge in the region was prevention.  Those most at risk were marginalized groups, particularly young people who were not easily reached by youth-friendly services.  Middle Eastern countries had low prevalence, but the risks were growing, particularly among men who had sex with men and anyone affected by drug use.

Responding to a query about whether there were sufficient financial resources to fight HIV/AIDS, Mr. Awasthi said that the financial crisis risked impacting the global response.  Major financing had been provided by the Global Fund to Fight AIDS, Tuberculosis and Malaria and the United States President's Emergency Plan for AIDS Relief (PEPFAR), but sustaining donor and national contributions was critical. Once people were placed on life-saving treatment, it must be sustained, yet there had been interruptions due to funding shortages. Some $25 billion was needed to reach universal prevention and treatment targets.

To a comment on the high percentage of HIV/AIDS cases in poverty-stricken southern Africa -– 91 per cent -- and a question about whether addressing poverty and HIV/AIDS presented a moral challenge for the panellists, Mr. Kolker said “rights questions were absolutely central to the AIDS response”.  Indeed, AIDS and a host of other factors contributed to poverty.  The difference between rich and poor and the power expressed in sexual relationships were contributory factors. People represented in the statistic cited came from all economic classes, underscoring the importance of an international, but tailored, response.

Mr. Lindblad added that it was important not to see AIDS in an isolated context, but rather, as part of overall poverty eradication efforts. He urged integrating the HIV/AIDS response with efforts to achieve the Millennium Development Goals.

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For information media • not an official record