When HIV was discovered in the early 1980s, one shock came after another. First, it is a virus for which there was no cure. Second, it has serious health implications and, before the arrival of antiretroviral therapy, would likely lead to mortality. Finally, most shocking perhaps was the discovery that it was trans-generational, which means babies being born with the virus.
From a medical and public health perspective, as well as from a social and humanitarian angle, this was the worst challenge healthcare was about to face and continues to face 30 years into the pandemic. Children living with HIV and babies born with the virus are the most painful aspects of the HIV crisis.
Preventing mother to child transmission of HIV has made extraordinary progress in reversing the epidemic. However the numbers still remain very high. An estimated 3.3 million children are currently living with HIV according to a UNAIDS estimate from 2012. Every day 700 children acquire HIV and, without treatment, half of all children born with HIV will die by the age of two and the majority will die by the age of five.
The challenge of protecting children from HIV
UNAIDS estimates that over 90 per cent of children who acquired HIV in 2011 are in Sub-Saharan Africa where HIV has taken a real toll. In 2012 there were 210,000 children who died of AIDs-related illnesses.
The task is still very daunting, the challenges deeply complex.
When former US President Bill Clinton addressed the 20th International AIDS Conference in Melbourne this month, he shared how organizations like the Clinton Health Access Initiative (CHAI) are supporting programmes to prevent transmission of HIV from mothers to their babies, as well as the treatment of children with HIV in some of the poorest regions, including Sub-Saharan Africa. "Enormous progress has been made but a lot still needs to done," he said.
Paediatric AIDS has to gather momentum in the field of researching prevention and treatment of HIV in children. The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) is a new initiative by the International AIDS Society to address outstanding research gaps related to the clinical management and delivery of services to infants, children and adolescents affected by HIV in resource-limited settings. The initiative was formed in 2012 and over the last two years several medical scientists have been awarded CIPHER research grants including seven new recipients at AIDS 2014.
In a symposium at the conference about growing tomorrow's leaders in paediatric AIDS, new CIPHER grantees presented their research topics. A lot of hope relies on these proposals to address critical prevention and clinical management questions in the context of children and AIDS.
As the battle against HIV continues, the issue of children living with the virus needs greater attention and, if we are to achieve an AIDS free generation in the years to come, treating children living with HIV and ensuring that babies are born free of the virus is a crucial milestone.