Foreword
For almost three decades, the fight against HIV/AIDS was at the top of the world’s health agenda – an urgent priority that commanded commitment and compelled action.
That sense of urgency helped drive a global movement to end AIDS – from grassroots to governments to global organizations and partnerships. Targeted investment in innovation to reach and treat those at greatest risk have produced significant results, averting millions of new infections and giving new hope to families living with HIV around the world.
We may be justly proud of this progress, but we cannot let the world conclude that it means our struggle is over.
It is far from over – especially for children.
Despite our enormous progress, over half of the world’s new infections last year were among women, children and adolescents. Every day, around 400 children become infected – enough to fill nearly six school buses. Far too many pregnant women living with HIV are still not receiving treatment, putting their own lives, and the lives and futures of their unborn children, at risk. Far too many children have dropped out of treatment, or never received it in the first place.
The situation is especially dire for adolescents – and for adolescent girls most of all.Every two minutes, an adolescent between the ages of 15 and 19 is infected with HIV – two thirds of them girls. And while deaths due to AIDS have decreased for all other age groups since 2010, among adolescents deaths have actually increased. AIDS is a leading cause of death of adolescents globally – and especially in sub-Saharan Africa.
We have not come this far to give up the fight. Together, we need to recapture the urgency that this issue deserves.
To end AIDS in children once and for all, we need to focus on both treatment and prevention, with a deeper focus on the life cycle of the child, beginning during pregnancy, in infancy and childhood, and through adolescence.
We need to finish the job of preventing mother-to-child transmission by providing lifelong HIV treatment to 95 per cent of pregnant women living with HIV by 2018 and maintaining support for them throughout their lives.
We also need to urgently scale up HIV testing – including at birth, at six to eight weeks of age, and throughout the breastfeeding period – and increasingly with a focus on adolescents, with programmes that directly target those at greatest risk: adolescent girls, gay and bisexual boys, adolescents who use drugs, and sexually exploited youth.
Just as urgently, we need to scale up treatment coverage to 95 per cent of all children and adolescents living with HIV by 2018. That means reaching those children who have fallen through the cracks and have not been tested, or who have dropped out of regular care and treatment altogether. And it also means integrating our efforts to reach children living with HIV with health, nutrition and protection services.
Fortunately, there is no mystery about what to do. This is a disease that we know how to prevent and treat, and new innovations are increasing our ability to reach children and communities living far from clinics and medical care.
What we need is a resurgence of will – and a rejection of complacency.
Because wouldn’t this generation of children one day look back and wonder how we could have been so close to ending AIDS – how we had the proven knowledge to do so – and still fell short? Wouldn’t they ask why we threw away our success – why we squandered our great progress – when we were so close?
We are in a position to change the story – and finish the fight.
Anthony Lake
Executive Director, UNICEF