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Children and AIDS: A stocktaking report

Actions and progress during the first year of Unite for Children, Unite against AIDS

UNAIDS, Unicef, World Health Organization (WHO)

January 2007

SARPN acknowledges Unite for Children, Unite against AIDS as a source of this document:
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AIDS is redefining the very meaning of childhood for millions, depriving children of many of their human rights – of the care, love and affection of their parents; of their teachers and other role models; of education and options for the future; of protection against exploitation and abuse. The world must act now, urgently and decisively, to ensure that the next generation of children is AIDS-free.
UNICEF, A Call to Action: Children, the missing face of AIDS1

Twenty-five years into the AIDS epidemic, the children in its path remain at grave risk. It is estimated that 2.3 million children under 15 years old are infected with HIV, 15.2 million children under 18 have lost one or both parents to AIDS, and millions more have been made vulnerable. The risks inherent in these statistics are many, as children affected by AIDS may experience poverty, homelessness, school drop-out, discrimination, loss of life opportunity and early death.

Unite for Children, Unite against AIDS was launched in October 2005 with the goal of putting the ‘missing face’ of children at the centre of the global HIV/AIDS agenda. In the year since, the world’s response to protect and support AIDS-affected children remains tragically insufficient. But in important and positive ways, that is beginning to change.

This report takes stock of some of the most important actions and changes for children affected by HIV/AIDS that have taken place in the first year of Unite for Children, Unite against AIDS. Among other developments, the report finds that children and AIDS had by 2006 become more clearly integrated into national policy frameworks, including national plans of action (NPAs) and poverty reduction strategy papers (PRSPs) in at least 20 countries in sub-Saharan Africa. It finds increasing numbers of children now receiving treatment as a result of improved testing, lower drug prices and simpler formulations. It reports that in several countries, behaviour change has translated into declining HIV prevalence among young people. And the disparity between orphans and non-orphans in access to education has been reduced in several countries.

Over the past year, there has been a broad, growing recognition of the need to intensify and accelerate actions towards universal access to comprehensive prevention, treatment, care and support. Commitment to this goal by 2010 was affirmed by Heads of State and Government and their representatives participating in the 2006 High-Level Meeting on AIDS held at the United Nations in New York, 31 May–2 June 2006.

There is also a better understanding of how crucial it will be to achieve the targets established during the UN General Assembly Special Session on HIV/AIDS (2001) – and the targets for children articulated in the four programme areas of Unite for Children, Unite against AIDS – in order to achieve the goal of coming as close to universal access as possible.

It is acknowledged that the Millennium Development Goals (MDGs) – especially MDG 6, which is to halt and reverse the spread of HIV/AIDS by 2015 – will not be reached without integrating approaches to children and AIDS with approaches to child health and survival.

There are, however, huge gaps in progress:

  • Only 1 in 10 pregnant women with HIV in low- and middle-income countries is receiving antiretroviral (ARV) prophylaxis for preventing mother-tochild transmission of HIV.

  • Only 1 in 10 children needing antiretroviral treatment (ART) receives it – the others face a bleak and short-lived future.

  • At most, 1 in 25 children born to HIV-infected mothers receives cotrimoxazole prophylaxis to prevent opportunistic infections that can be fatal.

  • Children who have lost both parents – to AIDS or any other cause – are generally less likely than non-orphans to attend school.

  • Fewer than one in three young people in sub-Saharan Africa has the comprehensive knowledge about HIV that will help protect them against the virus.
This report seeks to identify discernible trends through the measurement of new and existing data against a baseline used here for the first time in the areas of preventing mother-to-child transmission of HIV, providing paediatric treatment, preventing infection among adolescents and young people, and protecting and supporting children affected by HIV/AIDS – the ‘Four Ps’.

Further, this report reviews progress towards support strategies identified as critical elements of a child-focused response. It seeks to illuminate some of the ways in which Unite for Children, Unite against AIDS has shown relevance and promise, as well as some of the ways it has failed to spur the global, regional and country mobilization required to address the problems facing children affected by AIDS. It will explore how Unite for Children, Unite against AIDS needs to move forward in the next year to achieve its ambitious goals.

UNAIDS provides a dynamic and flexible structure for broad participation in Unite for Children, Unite against AIDS based on the mandates, accountabilities and comparative advantages of each member of the UN family. Their contributions to the ‘Four Ps’ and the contributions of many other partners are acknowledged in the following pages.

  1. United Nations Children’s Fund, A Call to Action: Children, the missing face of AIDS, UNICEF, New York, 2005, p. 2.

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