UNICEF The United Nations Children's Fund

GENEVA, 23 December 2017—UNAIDS warmly welcomes the announcement by the United Nations Secretary-General that Henrietta Holsman Fore has been appointed as the new Executive Director of the United Nations Children’s Fund (UNICEF). Ms Fore is a champion of economic development, education, health and humanitarian assistance and was the first woman to serve as the Administrator of the United States Agency for International Development and as the Director of United States Foreign Assistance.

“We look forward to working closely with Henrietta Holsman Fore and continuing to collaborate with UNICEF on our common goals—stopping new HIV infections among children, ensuring access to HIV treatment and making sure that children living with and affected by HIV get the care and support they need,” said Michel Sidibé, Executive Director of UNAIDS.

UNICEF is a founding Cosponsor of UNAIDS and in 2011 joined UNAIDS, the United States President’s Emergency Plan for AIDS Relief and other partners to develop the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. The plan helped to significantly reduce new HIV infections among children in the countries most affected by HIV.

From 2010 to 2016 there was a 56% decline in new HIV infections among children in eastern and southern Africa. However, access to treatment for children continues to lag behind. Globally, just 43% of children living with HIV had access to life-saving antiretroviral therapy in 2016, compared to 54% of adults. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Mahabad Asanova’s first daughter was found to be living with HIV after being rushed to hospital with a high fever. For her second pregnancy, Ms Asanova had to wait 18 months before finding out that her son was HIV-negative.

By the time of her third pregnancy, however, things had changed dramatically. Within a month of her birth, Ms Asanova had been told that her daughter was HIV-negative. A revolutionary method of HIV testing of infants, dried blood spot (DBS) testing, had by then been introduced, significantly cutting the time for diagnosis.

“Waiting 18 months to know about the HIV status of my child was terrible,” Ms Asanova said. “I’m so relieved—dried blood spot testing completely changed my life.” Before DBS, children had to wait a year or more to be tested.

DBS is simple: no sophisticated equipment or invasive testing methods are needed. After a prick on the newborn’s heel, a drop of blood is collected on filter paper and dried. The sample is sent to a laboratory for testing and the results are known before the infant is a month old, allowing infants living with HIV to be treated immediately with life-saving antiretroviral medicines.

“Before dried blood spot testing was widely introduced in 2013 in Kyrgyzstan, only around 15% of infants were diagnosed early,” said Edil Tilekov, HIV Programme Officer for the United Nations Children’s Fund (UNICEF). “In 2017, that figure grew to nearly 90%.”

Today, HIV science and diagnostics are becoming ever-more sophisticated. UNICEF is promoting point-of-care HIV diagnostic methods for infants that would yield an HIV diagnosis a mere two hours after collecting blood.

The introduction of DBS and improved training for doctors has helped to defuse some of the stigma against people living with HIV.

“Stigma among medical staff began to decrease as antiretroviral medicines were integrated into the primary health-care system,” Elmira Narmatova, Director of the Osh Oblast AIDS Centre, said. “It became more like a chronic disease, mortality declined.”

Children who are treated early fare better and the more the medicines work, the more confident parents become. Today, in part as a result of DBS, more than 95% of children living with HIV in Osh, Kyrgyzstan, access antiretroviral therapy.

Yet pockets of resistance remain. Despite early diagnosis, not all infants receive the medicines they need. “We are interviewing parents and medical staff to find out why some parents still don’t want to give their infants antiretroviral medicines,” said Mr Tilekov.

Informal conversations already provide clues: resistance may be due to religion, to scepticism about immunization or even to urban myths.

“Although much has been done to provide parents with information and train medical staff, there is still a lack of resources and trained personnel, so some parents will slip through the net and might not be briefed properly about side-effects,” said Mr Tilekov. “So, if their infants lose weight or don’t eat well after starting antiretroviral therapy, parents blame the medicines.”

When an infant or mother is tested for HIV in Osh, the laboratory sends the results to the Osh AIDS Centre, a pleasant house set among trees in a leafy suburb, its gates open in welcome. The hallways are decorated with images of the popular Vitaminka fairy tale, a comic strip that helps health workers and parents explain to children the importance of taking their antiretroviral medicines regularly.

By providing child-friendly spaces and psychosocial support in addition to medical treatment, the centre makes parents feel welcome and encourages them to visit, pick up prescribed medication and get tested regularly.

The centre, upgraded by the Ministry of Health together with UNICEF and UNAIDS with support from the Government of the Russian Federation, now treats more than 200 children and a psychologist provides psychosocial support to children living with HIV.

Away from social pressures and among friends, parents can exchange hopes for the future and find much needed support at the centre.

Ms Asanova looks relaxed as her fingertips touch across her lap, her olive-green dress contrasting with her cream-coloured hijab. Mahabad Asanova isn’t her real name, since she still worries about stigma and discrimination beyond the centre’s walls. But she isn’t afraid anymore, even though she is now expecting another child. Whatever happens, thanks to DBS, she will no longer face painful months of waiting for a diagnosis.

This story was originally published by UNICEF

In Mozambique there has been some progress in the fight against AIDS, notably in preventing mother to child transmission of HIV. But progress in preventing new HIV infections among adolescents (10-19) and improving testing and treatment in adolescent populations are still unacceptably slow.

Around 120,000 adolescents live with HIV (UNAIDS 2017). The data also reveals a worrying gender disparity: according to IMASIDA 2015, HIV prevalence among adolescent girls 15-19 is four times higher than for boys (6.5% vs 1.5%). Prevalence is also higher in urban areas than in rural.  Young women have higher odds of HIV infection due to various factors including gender norms, reduced access to information, and age-disparate sex. Additionally, not knowing one’s HIV status and engaging in high risk practices predisposes young people to the risk of contracting HIV. This highlights the need for adolescents and young people to have access to appropriate information as they explore their sexuality.

The AIDS epidemic must remain a global public health concern, according to UNICEF and UNAIDS. Innovative solutions must be adopted to speed up progress in preventing HIV infection of children and adolescents and ensuring those living with HIV get the treatment they need. 

In 2015, in the context of the youth-focused Sexual and Reproductive Health (SRH) and HIV prevention Geração Biz (Busy Generation) programme, UNICEF Mozambique partnered with line ministries of Youth and Sports; Health; Education and Human Development; UNFPA and the youth association Coalizão (Youth Coalition) to adapt the SMS-based technology for development platform U-Report and roll out the programme known as SMS BIZ. This was aimed at improving adolescent and young people’s access to comprehensive and personalised SRH and HIV information through SMS (for more information visit http://mozambique.ureport.in/).

SMS BIZ partners set up a counselling hub managed by Coalizão with 24 trained peer counsellors, equipped with ICT facilities and a reference guide on SRH, HIV and Gender-based Violence (GBV) prevention to facilitate their capability to respond to adolescents queries. The counseling service is totally anonymous so neither the counsellors nor users can identify the other. Counsellors respond to about 1,000 questions daily. A total of 350,000 questions were responded to date. Communication and promotion materials were developed to promote the counselling service while advocacy sessions were held in selected provinces in order to create synergies with different stakeholders. Partnerships with the three Telecom Operators allowed SMS BIZ partners to count on free un-limited SMS for the period of 2017-2020.

In only two years, SMS BIZ/U-Report, has exceeded expectations with over 110,000 active adolescents and youth registered by September 2017, using the services for information on topics relevant to them.

Adolescents and young people registered have been engaged in discussions addressing misconceptions about SRH, HIV prevention and treatment, and increasing uptake and linkages to HIV and GBV services. Results from a poll show positive results, with 65% of adolescents and young people that responded to the poll were referred and adhered to health facilities during the counselling session for additional individual face-to-face counselling, consultation or treatment.

However, until recently, the challenge has been attracting as many girls as boys to the platform with a ratio of 60% boys - 40% girls. Raima Francisco Manjate, one of the SMS BIZ/U-Report stellar peer counsellors officially launched the Girl-to-Girl invite system on the International Day of the Girl Child on October 11th, with an intervention at the National Girls Conference organized in the context of the UN Joint programme Action for Girls, funded by the Swedish Government. The results have been outstanding: in 72 hours, more than 8,600 girls were successfully registered, the girls' user population grew from 4% to 44%, with five girls registering more than 50 friends and winning the competition.

Today, the total number of SMS BIZ/U-Report users reached 130,000.

The five adolescent and young girls, winners of the competition, have been awarded today at the World AIDS Day Celebrations, in Maputo and in the provincial capitals of Quelimane, Nampula and Beira in recognition of their efforts in mobilising friends to adhere to this important counselling service.

Neima Muianga, 20 years old and Cristina Djive, 18 years old,  both from the capital Maputo, were the two girls awarded today at the WAD ceremony, by the following high-level dignitaries such as Mr. Carlos Agostinho do Rosario, Mozambique Prime Minister, Mr. Luiz Loures, UNAIDS Deputy Executive Director, Ms. Nazira Abdul, Health Minister and Ms. Clarisse Machanguana, UNICEF National Ambassador.

Neima was thrilled when she discovered she had won the competition: “I feel happy about it. I have sent various SMS to contact numbers on my list, my neighbours, church members and even girls or young women I would bump into in the streets. SMS BIZ is very important for us. I don’t feel comfortable speaking with my parents about sexuality as this is taboo in Mozambique”.

"It is an excellent example of how young people can empower each other through technologies and innovative projects. Girl-to-Girl (G2G) is the kind of innovation that has an essential role for gender equality and health as we work to leave no one behind in implementing the sustainable development goals," said Luiz Loures, UNAIDS Deputy Executive Director, Assistant Secretary-General of the United Nations.

Now that the SMS BIZ/U-Report initiative has been scaled up at national level, SMS BIZ partners expect to reach and engage approximately 400,000 adolescents and young people by 2020. According to Cristina “this initiative cannot stop. So far, it has been a great experience for us.”

New report highlights urgent need for an improved HIV response for children and adolescents

ABIDJAN/DAKAR/NEW YORK/GENEVA, 5 December 2017 – More than four decades into the HIV epidemic, four in five children living with HIV in West and Central Africa are still not receiving life-saving antiretroviral therapy, and AIDS-related deaths among adolescents aged 15-19 are on the rise, according to a new report released today.

While acknowledging progress in several areas, the report Step Up the Pace: Towards an AIDS-free generation in West and Central Africa, jointly published by UNICEF and UNAIDS, shows that West and Central Africa is lagging behind on nearly every measure of HIV prevention, treatment and care programmes for children and adolescents. In 2016, an estimated 60,000 children were newly infected with HIV in West and Central Africa.

“It is tragic that so many children and adolescents today are not receiving the treatment they need just because they have not been tested,” said Marie-Pierre Poirier, UNICEF’s West and Central Africa Regional Director. “We need to make better use of innovations to increase early diagnosis and improve access to HIV treatment and care for children. For example, the point-of-care technology diagnostic brings testing closer to where children attend health services and self-testing can be a good option for adolescents who may be more comfortable with it.”

The region’s coverage of life-saving antiretroviral therapy among children living with HIV is the lowest in the world because many countries have limited capacity to perform the tests needed for early infant diagnosis of HIV. Without knowing a child’s HIV status, his or her family is less likely to seek the treatment that could prevent the tragedy of a child’s death from AIDS-related illnesses.

The situation is worse among adolescents. The annual number of new HIV infections among those aged 15–19 years in the region now exceeds that of children aged 0-14 years. These new infections occur mostly through unprotected sexual contact and among adolescent girls. Equally concerning, according to the report, is that West and Central Africa has recorded a 35 per cent increase in the annual number of AIDS-related deaths among adolescents aged 15-19 years — the only age group in which the number of AIDS-related deaths increased between 2010 and 2016.

With the region’s youth population expected to grow significantly within the coming decades, especially in countries like the Democratic Republic of the Congo and Nigeria, the numbers of children and adolescents becoming infected with HIV and dying from AIDS is likely to remain high, unless the HIV response – both prevention and treatment – improves dramatically.

The report highlights that the 24 countries that make up the West and Central Africa region are home to 25 per cent of children aged 0–14 years living with HIV worldwide.

“Leaders of the region have endorsed a Catch-Up plan aiming to triple the number of people on treatment in the region – including children – by the end of 2018, the key issue now is to accelerate implementation,” said Luiz Loures, UNAIDS Deputy Executive Director. “Countries should urgently put in place more effective strategies for early infant diagnosis of HIV, and start reducing inequity in children’s access to treatment.”

The report proposes key strategies that will enable countries to accelerate progress in curbing the spread of disease. These include:

1. A differentiated HIV response focusing on unique epidemiological and local contexts in each country and community.
2. The integration of HIV services into key social services including health, education and protection.
3. Community ownership and local governance of the HIV response including working with families, better placed to help reduce stigma, access prevention and treatment.
4. Investment in innovations to remove barriers to scale-up including new diagnostic and biomedical approaches such as point of care diagnostics, HIV self-testing and pre-exposure prophylaxis.

UNICEF announced last week that at the current pace of progress, the global 2020 Super-Fast-Track targets to end AIDS among children will not be achieved.

***

Key facts from the report:

• Prevention of mother-to-child transmission of HIV coverage has increased 2.5-fold between 2010 and 2016 (from 21 per cent to 49 per cent), with some countries such as Benin, Burkina Faso and Cabo Verde now providing these services to more than 80 per cent of the pregnant women living with HIV.
• West and Central Africa has the lowest paediatric antiretroviral treatment coverage in the world, with only 21 per cent of the 540,000 children (0-14) living with HIV receiving antiretroviral treatment in 2016 – compared to 43 per cent globally.
• Today, West and Central Africa accounts for 37 per cent of the world’s AIDS-related deaths among children: about 43,000 AIDS-related deaths occurred among children in West and Central Africa in 2016, a decrease of 31 per cent compared to 2010.
• There were 62,000 adolescents (15-19) newly infected with HIV in 2016, unchanged compared to 2010.

• Adolescent girls and young women continue to be the most affected, with women making up nearly three out of five of all adolescents aged 10-19 years living with HIV across West and Central Africa.

Note to editors:

The Report is available at: https://www.unicef.org/publications/index_101480.html

More information is available at: www.childrenandaids.org

About UNICEF

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children, visit www.unicef.org

About UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube. For more information about UNAIDS and its work, visit www.unaids.org