UNAIDS 2010 report documents significant progress in reducing pediatric HIV infection

The just-released UNAIDS 2010 report on the global AIDS epidemic reflects that there is increased momentum to eliminate pediatric HIV and AIDS worldwide, and documents significant progress in increasing access to services to prevent mother-to-child transmission (PMTCT) of HIV, reducing new infections in children, and providing treatment for children, mothers, and families living with the virus.

According to the report, 370,000 children were infected with HIV through mother-to-child transmission in 2009, a 24% drop from just five years earlier.  During the same period in southern Africa – where the pandemic is at its worst – there were 32% fewer children newly infected, thanks to a rapid scale-up of PMTCT services coordinated by national governments, nongovernmental organizations like the Elizabeth Glaser Pediatric AIDS Foundation, communities, and other partners.

Some African countries – such as Botswana, Namibia, South Africa, and Swaziland – have achieved more than 80% PMTCT coverage,  several others are getting closer to this goal, and the global gap in reaching this target is becoming more concentrated in fewer countries with great unmet need.  The benefits of broad PMTCT coverage are clear – near universal PMTCT access has allowed Botswana to reduce new infections in children from 4,600 in 1999 to about 890 children in 2007.

The Elizabeth Glaser Pediatric AIDS Foundation continues to play a critical role in the fight to eliminate pediatric AIDS:  Foundation-supported programs provided PMTCT services to nearly 2.5 million pregnant women worldwide in 2009, and about a quarter of women that received antiretroviral drugs (ARVs) for PMTCT in low- and middle-income countries during 2009 did so through Foundation-supported programs.  

"Despite the notable progress by the Foundation and other partners, nearly half of pregnant women in need still did not have access to ARVs for prevention of mother-to-child transmission in 2009," said Nicholas Hellmann, M.D., Executive Vice President of Medical and Scientific Affairs for the Elizabeth Glaser Pediatric AIDS Foundation. "However, the rapid expansion of PMTCT efforts has dramatically increased HIV testing among pregnant women and led to more seamless integration of PMTCT services into routine pregnancy care – both identified by the report as needed action items."

UNAIDS also documents progress in reaching more children and pregnant women with treatment for HIV/AIDS.  Overall, more children living with HIV were receiving antiretroviral therapy in 2009, a total of 354,000.  But children are still less likely than adults to receive lifesaving treatment.  And while about 90% of the world's children living with HIV are in sub-Saharan Africa, only 26% of children in need in the region are receiving antiretroviral therapy, which lags behind the global average.  Early identification and treatment of HIV-positive infants is critical to their survival – without it, most will not live past their second birthdays.

Pregnant women and mothers living with HIV are also not receiving the treatment they need to protect their own health; only about 51% of pregnant women living with HIV were screened for treatment eligibility for their health in 2009. The report also indicates that some countries like Swaziland, where the Foundation supports sizable programs, have demonstrated success through major initiatives to integrate HIV treatment into maternal and child health settings.

During the coming year, considerable Foundation efforts will focus on helping countries to implement the World Health Organization's recently-updated HIV treatment and PMTCT guidelines, which will address some of the gaps indicated by the report: putting more pregnant women on treatment for HIV/AIDS, and protecting infants from HIV during pregnancy, childbirth, and through the breastfeeding period.

"The progress – and the continued need – identified by UNAIDS gives us achievable targets in our mission to eliminate pediatric AIDS, and to ensure a healthy future for children and families living with HIV throughout the world," said Hellmann.