By Prarthana Mitra
A recent report by UNICEF took stock of the global progress in ending AIDS among children and adolescents by 2030, concluding that India was the farthest behind, having accounted for an estimated 120,000 cases in 2017.
South Asia’s progress: Remarkable but not all-encompassing
India contains the highest number of people aged 0-19 years living with HIV in South Asia. More than half of these children won’t live to turn five, the report revealed.
The region on the whole, however, has managed to bring about a considerable decline in HIV risks and vulnerability among children, but still has miles to go when it comes to adolescents above the age of nine, pregnant women, and mothers.
A remarkable record was set in 2017 by South Asia in terms of tackling the transmission among children. In 2017, the number children under the age of 5 who were newly diagnosed with HIV fell by 43% compared to 2010, marking a decrease greater than the 35% recorded globally, held the report titled Children, HIV and AIDS: The World in 2030.
At the same time, a staggering 360,000 adolescents are projected to die of AIDS-related diseases between 2018 and 2030 without additional investment in HIV prevention, testing and treatment programmes, the report also noted in its introductory statement. The report also predicts two million new infections by the end of 2030.
Besides India, other countries lagging in the war on the HIV epidemic are Pakistan, with 5,800 children and adolescents suffering from AIDS, followed by Nepal (1,600), and Bangladesh (less than 1,000).
Off the 2030 target so far
Released on the heels of World AIDS Day, which is marked on December 1, UNICEF’s roundup sounds a dire warning, that around 80 adolescents will be dying of AIDS daily around the world if “we don’t accelerate progress in preventing transmission”.
73% of the afflicted children between 0-14 years had been initiated on lifesaving antiretroviral therapy (ART) according to the latest report, marking a 50% increase than the earlier 2010 data. The new report also indicated a decline in AIDS-related deaths and deceleration in new infections, but acknowledged that the rate of decrease is not fast enough to make good on the pledge to eradicate AIDS by 2030.
“The report makes it clear, without the shadow of a doubt, that the world is off track when it comes to ending AIDS among children and adolescents by 2030,” said UNICEF chief Henrietta Fore. Against the global target reduction in the number of HIV-infected children by 2030 to 1.4 million, the latest report projects 1.9 million cases, proving that the world is off-track by around 500,000.
Issues with transmission and treatment
Efforts to prevent transmission and treat infection are nowhere near the requisite when it comes to contagion from mothers to babies, and among older children.
Currently, three million people, 19 years and younger, are infected with HIV worldwide. In fact, the slowest rate of decline was noted in cases of infection among older children, proving that existing awareness and therapy programmes are missing the mark by a huge margin.
Although cases of transmission from mother to child fell by 40% in the last eight years, the report found that girls still account for two-thirds of all adolescent HIV infections.
How we can achieve the global target?
To meet the global targets, decentralised efforts have to be made to ensure adequate access to HIV prevention, care and treatment services, and testing and diagnoses. In developing countries, economic constraints and social stigma often impede HIV patients from seeking out help. Children and adolescents in India are often unaware of the infection and its ramifications, and even when tested HIV-positive, rarely adhere to proper treatment. In such cases, sensitisation programmes must address key drivers of the epidemic and raise awareness about how the infection may or may not spread.
The report notes that basic shortcomings like these pose obstacles to UNICEF’s vision of an AIDS-free generation. Among the suggestions proffered by the timely report are upscaling family-centered testing to help identify undiagnosed children living with HIV, and using technology to increase awareness and proactive medical service delivery.
Prarthana Mitra is a stafff writer at Qrius.
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