Antiretroviral Therapy Access Increases in Developing Countries, Hundreds of Thousands of Child Deaths Preventable, U.N. Report Says

The number of HIV-positive people in developing countries with access to antiretroviral therapy increased 54% to two million people in 2006, but hundreds of thousands of children died of AIDS-related illnesses due to a lack of access to the drugs, according to a report released on Tuesday by UNAIDS, UNICEF and the World Health Organization, Reuters Africa reports. The report found that five million people remain without access to antiretrovirals and that 15% of the 780,000 children in need of antiretroviral drugs had access to treatment by the end of last year. Only 4% of HIV-positive children received the antibiotic co-trimoxazole, recommended by WHO for HIV-positive children and infants who contracted the virus from their mothers during birth. About 380,000 children last year in developing countries died of AIDS-related illnesses, most of which were preventable, according to the report. Mother-to-child transmission rates remain "particularly aggressive" in developing countries, compared with high-income countries, where rates have dropped to below 2%, the report said. According to the report, 11% of HIV-positive pregnant women in low- and middle-income countries have access to antiretrovirals to prevent mother-to-child transmission, and many infants born HIV-positive go undiagnosed and are subsequently untreated. Sub-Saharan Africa, where about 25 million people with HIV/AIDS and 85% of all HIV-positive pregnant women live, showed the most severe treatment access problems, the report found. Children account for 14% of those in need of antiretroviral treatment in the region but only 6% are on such treatment regimens, according to the report.

Recommendations, Reaction
The report said that a "greater effort should be made to follow up HIV-exposed children and to determine the HIV status of all children born to mothers living with HIV/AIDS so that appropriate care and support can be provided." The United Nations agencies called for increased investment in tests to detect HIV in infants and in fixed-dosed pediatric drug formulations that could raise survival rates of HIV-positive infants and children. The agencies also recommended more screening for other sexually transmitted infections and tuberculosis to help reduce the spread of HIV (MacInnis, Reuters Africa, 4/17). "The significant progress outlined in this report in scaling up access to treatment is a positive step forward for many countries in achieving their ambitious goals of universal access to HIV prevention, treatment, care and support," Peter Piot, executive director of UNAIDS, said, adding, "However, new data in the report also sho[w] that there is still a long way to go, particularly in the widespread provision of treatment to prevent mother-to-child transmission of HIV, which remains one of the simplest and cheapest proven prevention methods available" (WHO release, 4/17).

The report is available online. Note: You must have Adobe Acrobat to view this report.

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