UNICEF The United Nations Children's Fund

Child marriage is widespread across much of Latin America and the Caribbean, accounting for around 23% of marriages in the region, despite laws against it.

The impact of child marriage and early unions (where one of the members is aged below 18 years of age) on girls and their societies can be devastating. Evidence shows that there is a strong link between child marriage and early unions with child pregnancy, maternal and infant mortality, lower education levels for girls and lower ranking on the human development index. And child marriage and early unions make girls more vulnerable to contracting sexually transmitted infections, including HIV.

At a high-level side event co-hosted by the Permanent Missions of Panama and Guatemala to the United Nations in collaboration with UN Women, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA) and UNAIDS, lessons learned and programmatic and policy options to address child marriage in Latin America and the Caribbean were presented.

In the event, which took place on 17 March at the United Nations Headquarters in New York, United States of America, during the sixty-first session of the Commission on the Status of Women, the participants recognized that child marriage and early unions are a violation of human rights and are a grave threat to the lives, health and future development of girls.

The event focused on the importance of supporting legislative reforms to raise the legal age of marriage to 18 and promoting programmes to empower girls and young women.

The event identified successful approaches and strategies for reducing the rates of child marriage. For example, Panama—where an estimated 26% of girls are married before the age of 18 and approximately 7% before the age of 15—has reformed its national legislation on the legal age of marriage. The minimum legal age for marriage in Panama is now 18 years, as is the age of consent. Previously, with parental permission girls aged as young as 14 years and boys aged 16 years could marry. In Guatemala, thanks to advocacy actions led by UN Women, civil society and international cooperation, reforms to the civil and penal codes have been approved to increase the minimum age for marriage to 18 years.

Since 2015, UNAIDS has partnered with UN Women, UNICEF, UNFPA and PAHO/World Health Organization in a joint initiative on eliminating child marriage and early unions that supports government actions to ensure that, throughout their life cycle, the multiple needs of girls and women are recognized and guaranteed.

UNAIDS is working with countries to eliminate gender inequalities and all form of violence and discrimination against women and girls by 2020, as outlined in the 2016 United Nations Political Declaration on Ending AIDS.

The Government of Malawi and the United Nations Children’s Fund are testing the use of unmanned aerial vehicles (UAVs, or drones) to explore cost-effective ways of reducing waiting times for HIV testing of infants. UAVs have the potential to cut waiting times dramatically and if the tests are successful they will be integrated into the health system alongside the use of other types of transport and other new technologies.

It currently takes an average of 11 days to transport samples from health centres to a testing laboratory, and up to eight weeks for the results to be returned. This means that mothers could be waiting for as long as three months to receive a test result for their children. The longer the delay between tests and results, the higher the loss to follow-up of children living with HIV.

UAVs have been used in the past for surveillance and assessments of disaster, but this is the first known use of UAVs on the continent for the improvement of HIV services.

The first successful test flight completed a 10 km route from a community health centre to the Kamuzu Central Hospital laboratory in Lilongwe. The test flights, which are assessing viability, including costs and safety, will continue until 18 March.

Responding to the challenge and opportunity posed by the interconnected Sustainable Development Goals (SDGs), leaders in health and education from across the world came together on the sidelines of the SDG Summit to discuss ways in which the health and education sectors can collaborate and integrate towards joint, people-centered results.

Convened by the Global Partnership for Education, the Global Fund to Fight AIDS, Tuberculosis and malaria, UNICEF and UNAIDS together with the United Nations Foundation and the Global Poverty Project on 26 September 2015, the high-level roundtable stressed the need for adequate financing in health and education to meet the SDGs.

Participants speaking at the event included Julia Gillard, Board Chair of the Global Partnership for Education and former Prime Minister of Australia, Gordon Brown, UN Special Envoy for Global Education, Tedros Adhanom Ghebreyesus, Minister of Foreign Affairs for Ethiopia, Mark Dybul, Executive Director of the Global Fund, and Jan Beagle, UNAIDS Deputy Executive Director. Participants agreed that putting people—particularly women and girls—at the center of the collective health and education efforts will be the key to success in the SDGs.

Adolescent girls, predominantly in sub-Saharan Africa, face higher risks of HIV infection. In 2014, an estimated 60% of all adolescents aged 15-19 years living with HIV were girls. Strong evidence shows that keeping adolescent girls and young women in school reduces the risk of HIV infection. Better educated young women are also more likely to delay sexual debut, to use condoms more frequently, to delay marriage and childbearing and to have better earning potential.

Participants at the event noted that there is significant work to be done to further collaboration between the health and education sectors but that there are good experiences of multisector responses and existing platforms to build on, including those established in the global AIDS response.

Emphasizing how gains in the AIDS response have been proven to maximize impact across other development outcomes, Ms Beagle said: “The AIDS response has shown the value of a multi-sectoral and people-centered approach. From the outset, it was clear HIV was much more than a health issue. It is a development issue, a rights issue, a gender issue that has inclusion of affected communities and evidence and rights-based approaches at its core. Lessons learned from this can be transferred not just to health and education, but across the SDGs.”

Concluding the roundtable, participants committed to continue their engagement, invest in girls’ health and education, focus joint efforts on evidence-based strategies, apply lessons learned through other sectors and monitor success. They stressed the importance of building on the momentum for cross-sectoral collaboration created at the Summit and continuing the dialogue to further advance the integration agenda.

A multimedia campaign led by the MTV Staying Alive Foundation in conjunction with the Bill & Melinda Gates Foundation, PEPFAR, the Elton John AIDS Foundation, UNICEF and UNFPA has prompted more than 47 000 young people to seek HIV testing and counselling services in Nigeria.

An educational initiative, On Tour with MTV Shuga—created around the award-winning drama series MTV Shuga—trained 160 Nigerian peer educators to facilitate HIV testing and to spread information and positive messaging based on the show in their communities. Of the more than 47 000 young Nigerians who were tested for HIV, 688 were found to be HIV-positive and were referred for HIV treatment.

Since its launch in 2009, MTV Shuga—a modern day drama about love, sex and relationships among Nigerian youth—has reached up to 550 million people worldwide, while 40 million people have been reached via social media. A total of 122 broadcasters are currently lined up to air the new season IV of the show. Among the topics covered in the new season are first sex, grooming of adolescent girls, prevention of mother-to-child transmission of HIV, disclosure of HIV status, sexual assault within a relationship, stigma, mentoring and the use of helplines.

Despite significant achievements, too many of the world’s poorest children face inequalities that are having a dramatic impact on their health, education and future prospects, warns UNICEF in a report published on 23 June.

In Progress for children: beyond averages, the final report on child-related Millennium Development Goals (MDGs), UNICEF highlights that millions of children and young people are still dying early, missing out on school, living in poverty and being disproportionately affected by the AIDS epidemic.

“The MDGs helped the world realize tremendous progress for children – but they also showed us how many children we are leaving behind,” said UNICEF Executive Director Anthony Lake. “The lives and futures of the most disadvantaged children matter – not only for their own sake, but for the sake of their families, their communities and their societies,” he added.

The report acknowledges that huge strides have been made in attaining MDG 6–combatting HIV/AIDS, malaria and other diseses.  For instance, between 2001 and 2013 new HIV infections have declined by 58% in children under 15, mainly due to progress in the prevention of mother-to-child transmission of HIV. The Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive has helped achieve a rapid expansion in the availability of antiretroviral medicines to pregnant women found to be living with HIV.

However, only 23% of HIV-positive children received such life-saving medicines in 2013 (compared to 37% of adults) and, in addition, adolescents aged 10-19 are the only group that has not seen a decrease in AIDS-related deaths in recent years.

The report also notes that about 35% of the 1.9 million people newly infected with HIV were young people aged 15-24. Adolescent girls are still most affected by HIV and in some countries are two to three times more likely to be infected than their male counterparts.

Progress for Children highlights a number of other such disparities and areas of deep concern across the spheres of health, education and income. It contends that as the era of the MDGs draws to a close, making way for preparations among world leaders to adopt new Sustainable Development Goals, disadvantaged children must be at the heart of these goals and targets.

The report also argues that better data collection, that tells a more rounded story and is not simply reliant on averages such as those used to measure the MDGs, will help identify the most vulnerable children and encourage tailor-made health and education solutions that help them to live longer, happier and healthier lives.

Tiny pellets make antiretroviral medicines more palatable for children

NEW YORK/GENEVA, 5 June 2015—Children affected by HIV and AIDS will benefit from the decision by the United States Food and Drug Administration to grant approval to a new antiretroviral formulation that can be mixed with food to make it easier for children living with HIV to take the life-saving medicines, UNAIDS and UNICEF said today.

“Treatment innovations such as this that replace unpleasant and bad tasting medicines are a real breakthrough, accelerating access to treatment for children and keeping our youngest healthy,” said Michel Sidibé, Executive Director of UNAIDS. “It is unacceptable that only 24% of children living with HIV have access to antiretroviral medicines.”

The oral pellets, manufactured by Indian generic medicines manufacturer CIPLA, contain an antiretroviral formulation of lopinavir and ritonavir that can be mixed into a child’s food. The treatment is heat stable and more palatable than medicines currently available, making it particularly suitable for treating very young children.

“This new formulation is a step in the right direction towards saving more lives of children living with HIV,” said Craig McClure, UNICEF’s Chief of HIV and AIDS and Associate Director, Programmes. “We expect it to greatly improve treatment access for many more children and support UNICEF’s equity focused programming aimed at reaching the most disadvantaged children throughout the world.”

HIV infection progresses rapidly in children and, in highly impacted countries, is a major contributor to child morbidity and mortality. Without treatment, one in three children who become infected with HIV will die before their first birthday. Half will die before their second birthday.

Early initiation of antiretroviral treatment in children as recommended by the World Health Organization substantially reduces the risk of death. Many countries have not been able to fully implement the WHO recommendation because of the challenge of not having a more appropriate, heat stable and palatable paediatric formulation of lopinavir/ritonavir used as part of the treatment options for children under 3 years of age.

Despite global efforts to accelerate access to HIV paediatric care and treatment, fewer than 800 000 of the 3.2 million children living with HIV worldwide had access to antiretroviral medicines in 2013.

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.

To commemorate this year’s Mother’s Day, UNICEF and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) released a new video and special website featuring mothers who are HIV-positive.

In 2013 and 2014, UNICEF and the Global Fund asked six women in South Africa and Malawi to share their reflections, hopes and fears as they went through their pregnancies and the delivery of their babies, and in the months after their children were born.

A Journey of Motherhood acknowledges the particular challenges HIV-positive mothers experience to give birth to healthy HIV-negative children, and to remain healthy themselves. The initiative also stresses the progress made in providing HIV medicines to prevent new HIV infections among children worldwide.

Each year, approximately 1.5 million women living with HIV give birth. With no medical intervention, the risk of passing on the virus to their babies during pregnancy, delivery and the breastfeeding period can be as high as 45%. But today, medicine to prevent mother-to-child transmission of HIV—a single, daily pill—reduces that risk to 5% or less.

At the Cricket World Cup 2015, cricketing champions show their commitment to raise awareness around HIV and break down stigma and discrimination

AUCKLAND/GENEVA, 5 March 2015—Players and officials at the International Cricket Council (ICC) Cricket World Cup 2015, being held in Australia and New Zealand, are raising awareness around HIV in efforts to eliminate discrimination and increase solidarity around ending the AIDS epidemic. Thirteen World Cup matches, including the final on 29 March, are being dedicated to THINK WISE, a partnership between the ICC, UNAIDS and the United Nations Children’s Fund (UNICEF), which uses the spirit of cricket to support global efforts to end the AIDS epidemic.

“Cricket is one of the most popular sports in the world and the game’s champions have a real power to inspire young people and share knowledge about HIV,” said UNAIDS Deputy Executive Director Jan Beagle. “The support of the cricketing world demonstrates how ending the AIDS epidemic is a common goal for people from all walks of life.”

Umpires are wearing the THINK WISE logo on their shirts throughout the World Cup and a video message recorded by ICC Cricket World Cup 2015 Ambassador and Sri Lanka batting legend Kumar Sangakkara is playing on the giant stadium screens in all the matches featuring the campaign. Players and officials in the final match will wear red ribbons to show their commitment and solidarity for people living with and affected by HIV.

JP Duminy, Aaron Phangiso, Kyle Abbott and Wayne Parnell of the South African national cricket team took to the pitch with a team of young people in Eden Park, Auckland, New Zealand, to encourage young fans to learn more about HIV. This special event, organized by the THINK WISE partners, together with the New Zealand AIDS Foundation, Positive Women Inc. and Body Positive, New Zealand, is part of the ongoing efforts to bring the issue of adolescent AIDS to the forefront.

“Adolescents aged 10 to 19 years old are the only age group where deaths due to AIDS are not decreasing,” said Craig McClure, Chief of HIV/AIDS and Associate Director of Programmes at UNICEF. “Stigma and discrimination are major contributors to preventing early diagnosis, treatment and care among adolescents. We can and we must remove the shame that clings to a positive diagnosis.”

South African players talked to the young fans about how HIV has affected the lives of millions of people in their home country. Star All-rounder JP Duminy said, “HIV is a serious issue for my country, but no matter where you are in the world, it’s important to get the facts about HIV. With cricket, we can use the spirit of cricket to help break down the stigma and discrimination around the disease.”

Encouraging the fans to mix their passion for cricket with a passion for action on HIV, the South Africa cricketers also gave the youth attending the event tips on how to improve their batting, bowling and fielding skills during a coaching session.

In 2013, there were around 35 million people living with HIV globally, many of whom live in major cricket-loving countries, including India and South Africa. Young people are particularly affected by HIV. In 2013, there were 250 000 new infections among adolescents and AIDS was the second leading cause of adolescent deaths worldwide.

Many of the matches are taking place in New Zealand, which has a strong HIV prevention programme and where HIV prevalence remains low. Despite this success, people living with HIV continue to be affected by stigma and discrimination in New Zealand. A recent survey conducted by AIDS organizations in New Zealand found that 50% of people surveyed would be uncomfortable having food prepared by someone living with HIV.

“Being a low prevalence country for HIV means that HIV is generally regarded as non-existent in New Zealand, which can make living with HIV here an extremely isolating experience,” said Jane Bruning of Positive Women Inc. “Initiatives such as THINK WISE help to raise awareness, which helps to reduce HIV-related stigma and discrimination.”

About the ICC Cricket World Cup 2015

For more information on the ICC Cricket World Cup 2015, including team fixtures, go to: http://www.icc-cricket.com/cricket-world-cup.

The official tournament hashtag is #cwc15.

Fast facts:

• The ICC Cricket World Cup 2015 will be hosted by Australia and New Zealand.
• Fourteen teams: Afghanistan, Australia, Bangladesh, England, India, Ireland, New Zealand, Pakistan, Scotland, South Africa, Sri Lanka, United Arab Emirates, West Indies and Zimbabwe.
• Fourteen host cities: Adelaide, Auckland, Brisbane, Canberra, Christchurch, Dunedin, Hamilton, Hobart, Napier, Nelson, Melbourne, Perth, Sydney and Wellington.
• Forty-two pool matches—three in each host city.
• Every visiting team plays in both countries.

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. Learn more at unaids.org and connect with us on Facebook and Twitter.

UNICEF

UNICEF promotes the rights and wellbeing of every child, in everything we do. Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere. For more information about UNICEF and its work visit: www.unicef.org Follow UNICEF on Facebook and Twitter.

By Anthony Lake, UNICEF Executive Director and Michel Sidibé, UNAIDS Executive Director

When you are an adolescent, you are supposed to feel as if you could live forever. And, indeed, adolescents are less vulnerable to disease and more resilient. Their survival rates are as high as their youthful spirits. 

But HIV changes everything. It is shocking that more adolescents die every year from AIDS-related illnesses than from any other cause except road accidents. In 2013 alone, 120 000 adolescents died from AIDS-related causes: more than 300 every day.

It is even more shocking that the number of adolescents dying of AIDS is not decreasing when AIDS-related deaths have dropped in every other age group. And it is shameful that this is happening when we have the knowledge and tools to keep adolescents living with HIV alive and well and to prevent new HIV infections.

What can we do to bring back the invincibility of youth? We must begin at the beginning—and stay with adolescents throughout their lives.

The vast majority of adolescents who died of AIDS-related illnesses in 2013 acquired HIV during pregnancy, delivery, or in the first months of life—because their mothers were not receiving the antiretroviral medicines that greatly reduce the possibility of HIV transmission. Although we have made great strides, far too many mothers and their infants are still not getting the HIV services they need to survive and thrive.

The remaining 20 per cent of adolescents living with HIV were infected as adolescents—an uncomfortable fact whose causes we need to honestly confront. 

More than 250 000 15 to 19-year-olds were newly infected with HIV in 2013—and they are overwhelmingly girls.  In that age group, girls account for two out of three new HIV infections globally. In sub-Saharan Africa, that number jumps to nearly eight out of ten. In South Africa, more than 800 girls in this age group are infected with HIV every week.

Girls are more vulnerable to HIV because they are more vulnerable generally—to violence, including sexual violence, forced marriage and trafficking. They are far less likely than boys to have the information they need to protect themselves, but even if they have that information, they may not be empowered to use it.

The remainder of young people who acquire HIV during adolescence are often gay and bisexual boys, and boys and girls engaged in using drugs or selling sex. Many are never diagnosed, let alone treated—because they fear repercussion if they seek information, enter prevention programmes, or get tested.

Many adolescents feel misunderstood, but when it comes to HIV and adolescents, it is not just a passing phase. National health plans and health systems in the most affected countries do not track or focus on adolescents—and there is precious little data monitoring their health and development over the age of five. Too old for paediatrics and often deemed too young for adult health services, many adolescents fall through the cracks at a time they most need our attention.

We must do more to protect all adolescents and empower them to protect themselves and their health. In fact, we cannot end the epidemic without a global movement to end AIDS-related deaths and new HIV infections among adolescents.

There are promising signs that such a movement is gathering force.  More programmes are reaching out to adolescents, many steered by young people themselves. More countries are including adolescents in national AIDS agendas.

The United States of America recently announced a new investment of US$ 210 million to prevent new HIV infections among adolescent girls and young women. The Global Fund to Fight AIDS, Tuberculosis and Malaria recently announced US$ 14 billion in grant money, with a commitment to include a focus on the adolescents at greatest risk.

We need to build on this momentum. This week, leaders working to end the AIDS epidemic are coming together in Kenya to call for a new global target of reducing AIDS-related deaths among adolescents by 65% and cutting new HIV infections among adolescents by 75% in the next five years.

This ambitious goal is the centrepiece of All In, a new platform for action to end adolescent AIDS.  It concentrates on the areas where we need to accelerate progress: from improving data to identify the young people we are missing and provide a sharper focus on adolescents in national AIDS programmes…to fostering innovation in developing new technologies and approaches to engage adolescents more effectively...to advocating for more resources to reach every adolescent living with, or at risk of acquiring, HIV, before it is too late. 

Most of all, young people themselves need to be ‘all in’ to end adolescent AIDS. Already, they are helping steer this movement, calling for positive change. The more we engage them and support their leadership, the more successful our common efforts will be to end this epidemic together.

Anthony Lake is the Executive Director of UNICEF. Michel Sidibé is the Executive Director of UNAIDS.

All In to #EndAdolescentAIDS

All In to #EndAdolescentAIDS is a platform for action and collaboration to inspire a social movement to drive better results for adolescents through critical changes in programmes and policy. It aims to unite actors across sectors to accelerate reductions in AIDS-related deaths and new HIV infections among adolescents by 2020, towards ending the AIDS epidemic for all by 2030. It is convened by a leadership group that includes UNAIDS, UNICEF, UNFPA, WHO and PEPFAR, as well as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the MTV Staying Alive Foundation and the adolescent and youth movement represented by the HIV Young Leaders Fund on behalf of the PACT and Y+.