Two UNICEF reports released recently say that 90% of all paediatric AIDS cases globally are in Africa. Around 1000 children are born with HIV on the continent every day. According to the reports, ‘Narrowing the Gaps to Meet the Goals’ and ‘Progress for Children: Achieving the MDGs with Equity’, just a little over one-third of these children will have access to life-saving anti-retroviral therapies.
‘Most of the children live in the rural areas and the services are concentrated mainly in urban areas. In order to succeed we need a programme that goes and reaches the children where they live in their communities to be able to access the medical services that they need. This is not being done successfully in many parts of Africa at the moment’, said Professor Peter Mugenyi, of the Campaign to End Paediatric HIV/AIDS (CEPA), an advocacy campaign whose aim is to mobilise for an AIDS-free generation.
The proportion of pregnant HIV-positive women receiving medication to prevent HIV transmission to their unborn babies has increased in recent years and so has the proportion of HIV-infected children who receive treatment. But some countries still have a higher AIDS-related child mortality rate. In southern Africa, for instance, five countries have a 30% or higher under-five mortality. In South Africa, the child mortality rate of children under the age of five is 45%, compared to just 3% internationally and 7% in sub-Saharan Africa. The UNICEF reports say these deaths occur mainly in under-developed areas and have called for an equity-focused approach in the allocation of resources and services to reduce HIV infection and to treat AIDS in children.
‘Unless the services reach the people who are the targets of these services, the programmes cannot succeed. If you take a country like Uganda, you find that about 80% of the population lives in rural areas, and this is where the services need to go. This is where the strengthening of health systems needs to be’ Professor Mugenyi said.
But with dwindling financial aid from donors, the recommendation will yield no result. As international donors are rationing or withdrawing aid, Professor Mugenyi called on African governments to play their part to save the lives of their own babies.
‘Charity begins at home. We require our governments in Africa to take the initiatives to make sure that they increase their budgets to be able to cater with a programme that we know very well that Africa can do successfully ‘ eliminate paediatric AIDS on the continent’, he said.
African governments made a commitment in 2001 in the famous Abuja Declaration, promising that they will increase their health spending to 15% of their national budgets.
But up to now, only about six countries have fulfilled their pledges. Chairperson of the Campaign to End Paediatric HIV/AIDS, Graca Machel, added her voice to the call for African governments to increase their expenditure on health.
‘Frankly speaking, I think they need to get their priorities right. We need to show commitment from African governments that we take this issue seriously ‘ to increase the budget, to have the budget lines very clear that we are tackling paediatric AIDS seriously as a strategy. There is capacity to tackle this. It doesn’t make sense that we are in situations where you have the medicines somewhere in the capital, but they don’t reach the villages. We have to prove ourselves if we are to have the courage to look into the eyes of our own children and say, ‘we do care’,’ said Machel.
She cautioned that Africa is falling far short of achieving the Millennium Development Goals on improving child health and reversing mortality rates. This month, the world will meet at the United Nations’ head-quarters in New York to review progress on the MDGs. Machel decried the slow progress that has been achieved 10 years on.
‘You will hear again the same commitments which were made in 2000. It’s 10 years now. We are only left with five years. What is it that is going to change this time? What is it really that’s going to make a huge difference? The progress made in 10 (years) is relatively modest. But, in five years, we have the challenge of doubling, make it five times fold if you can’.
The Campaign to End Paediatric HIV/AIDS is calling on international donors to strengthen their support of AIDS programmes in Africa, saying they have a moral and ethical responsibility to continue their funding.