Joint Report Into HIV Prevention and Treatment in Children Finds ‘Stark Inequalities’ and Requires ‘Urgent Action’, WHO Warns

A recent report into children’s HIV rates, prevention, and treatment in 2020 has concluded that targets set for the year were not met, halting advances made in treating and preventing the disease. The report was a collaboration between the Start Free, Stay Free, AIDS Free initiative, UNAIDS, the United Nations Children’s Fund, and the World Health Organisation (WHO). The Start Free, Stay Free, AIDS Free initiative launched in 2015 and focuses on HIV in children and adolescents in 23 different countries with the highest HIV case numbers.

HIV remains a significant threat to public health worldwide; the WHO estimates that over 37 million people were living with the disease at the end of 2020, 1.7 million of which were children. The most significant region affected by HIV is Africa, with two-thirds of all cases worldwide occurring in the WHO Africa region. The report showed that 46% of children with HIV were not being treated in 2020, reflecting a decline in treatment rates. The numbers are even more shocking when compared to treatment rates in adults; only 26% of adults are not being treated, meaning that children are almost 40% less likely to be receiving treatment. As a result, mortality rates in children with HIV are also higher than in adults, with 15% of all AIDS-related deaths being among children, even though they make up only 5% of all HIV cases. Shannon Hader, the UNAIDS Deputy Executive Director, said in a statement to the WHO, “Despite early and dramatic progress, children are falling way behind adults and way behind our goals…This is about children’s right to health and healthy lives, their value in our societies. It’s time to reactivate on all fronts — we need the leadership, activism, and investments to do what’s right for our kids.”

This report comes in the midst of the COVID-19 pandemic. The conversation about global health inequalities is often centered around disparities in COVID-19 vaccine distribution between developed and developing countries. However, as attention is drawn to inequities in access to healthcare, it is essential to remember that other complex global health issues face societies today. In addition to finding differences in the treatment of children and adults with HIV, there were noticeable differences in treatment across countries. The WHO’s response to the report cited Botswana and the Democratic Republic of Congo as examples, where treatment coverages are 100% versus 39%, respectively. COVID-19 has other implications in areas with high HIV rates. Earlier in July, a WHO report showed that HIV is a risk factor for severe COVID-19 disease. Almost a quarter of HIV patients hospitalised for COVID-19 died.

Despite the findings of this report demonstrating a lack of progress, some positive sentiments remain. Angeli Achrekar, acting United States Global AIDS Coordinator, told the WHO, “While we are deeply distressed by the global paediatric HIV shortfalls, we are also encouraged by the fact that we largely have the tools we need to change this. So, let this report be a call to action to challenge complacency and to work tirelessly to close the gap.” The report has outlined key target areas and proposed actions to tackle this issue in the future, which hopefully will affect change.

For more information on the report, please visit the WHO website.

Clara Baltay