in 2006 will be over 540. 000 children under the age of 15 have contracted the HIV virus. Over 90% of these children come into direct contact with the virus at birth to show "vertical" by HIV-positive mothers.
The number of children who become HIV positive every year could be more than halved if pregnant women with HIV received a package of antenatal care services, including antiretroviral drugs that slow the advent of the actual disease (AIDS ). Expanding access to services provided by programs to prevent mother to child transmission of the virus is one of the four pillars (the "Four P ") of the Unite for Children, Unite against AIDS", launched 25 October 2005 by UNICEF, UNAIDS and other partners with the ultimate goal of a generation free from HIV / AIDS. The other 3 P aim to achieve progress in the fields of primary prevention of pediatric care and protection of children affected by AIDS - and are vital to reverse the impact of the disease.
In Latin America and the Caribbean, and the objective 'to provide adequate services to 100% of women who need them. Unfortunately, currently less than 30% of women who need those services actually benefit from it. 22 of the 24 countries of the region showed a HIV prevalence around al 1% tra le donne incinta. Nonostante la esistente prevalenza questo dato, l’accesso ai servizi di prevenzione della trasmissione verticale continua ad essere limitato da una serie di fattori sociali, tra cui la disuguaglianza tra le donne, la scarsa educazione e la poverta’ persistente. Senza azioni preventive, quasi un terzo dei bambini nati da madri sieropositive potranno contrarre il virus. Senza cure pediatriche, un bambino su due muore prima di compiere 2 anni.
“Fornire i servizi di prevenzione della trasmissione verticale alle madri e’ la nostra priorita’ a livello regionale. Nonostante esistano interventi efficaci, ogni anno centinaia di migliaia di bambini nascono con l'HIV, e molti di essi muoiono nel corso del primo year of life, "says Nils Kastberg, UNICEF Executive Director for Latin America and the Caribbean. Accelerating coverage of HIV / AIDS in the countries most in need and provide long-term antiretroviral treatment to keep mothers HIV in good health are the bulwarks of UNICEF at the regional level.
The answer to the prevention of vertical transmission at the regional and 'varied and extended, must be from increasing the availability' of HIV testing for pregnant women, including access to counseling services for HIV-positive women, to 'invest in research on alternative methods of nutrition breastfeeding breastfeeding for HIV-positive pregnant women.
One of the most 'successful UNICEF in this field and' alliance LSS - Lazos Sur Sur (South-South Laces) - from September 2004 that he committed at the forefront of the Brazilian government. Through the National Program of AIDS, the government has' committed to providing universal access to antiretroviral treatment in Bolivia, Cape Verde, Guinea Bissau, Nicaragua, Paraguay, Sao Tome and Principe, and Timor-Leste, the countries with the lowest common denominator - HIV prevalence and 'relatively low and potentially controllable. LSS The initiative is inspired to a model of human rights, quite innovative, based on responsibility, ' autonomy and collaboration by the governments of participating countries.
The initiative aims to achieve universal access to prevention, treatment and care, based dul right of every people to learn how to protect themselves from HIV, to know their HIV status, receive counseling before and after HIV test, receive care and treatment services to prevent transmission of the virus.
Since then, significant progress has been achieved mainly because 'the majority of governments have pledged to institutionalize programs to prevent vertical transmission of the process common services in health systems premises.
There is a significant and positive change in most 'of 10 out of 24 countries in the region - Ecuador, Peru, Guyana, Brazil, Chile, Argentina, El Salvador, Jamaica, Dominican Republic and Cuba - where 80% of pregnant women acceddono regular services to prevent transmission verticlae and are willing to take an HIV test, thus making 'feasible the achievement of 100% by 2010. Despite the figures give a positive view of the current situation, major inequities exist in the region, considering that in Ecuador and Bolivia only 30% of pregnant women regularly enjoys the services of prevention of vertical transmission.
With LSS, Nicaragua and Bolivia have institutionalized a National Strategic Plan to combat the epidemic. Nicaragua in particular has initiated the first delivery of antiretroviral treatment in the region and training of staff of the health system. Today 10 out of 17 regions of the country Nicaraguan offer services for the prevention of vertical transmission and 50 out of 153 municipalities have an HIV test available with a 400% increase of the application of the test nationwide. Paraguay has significantly expanded the program to prevent vertical transmission in all 18 health regions going from 4 709 to 35 000 pregnant women exposed to HIV tests, which implies an increase of 300%.
In Guatemala, in the capital, the project of the Clinical Hospital 17 Roosevelt, funded by the U.S. Fund for UNICEF, offers free HIV tests to more 'of
11. 000 people, and antiretroviral treatment to 1. 500 patients and 50 HIV-positive children. The situation has improved in the clinic 17 so that the rate of vertical transmission and 'becoming similar to that of Toronto, Canada.
of the leading countries of the regional response, Brazil is closer 'to all the objective of the campaign - reach 100% between 1996 and 2005 cases of vertical transmission decreased by 51.5% (669 cases in 2004, 530 cases in 2005, 109 in June 2006). Despite the improvements, a strong disparity 'access to preventive services vertical continues to be among the regions of the country: in the north-east 35% of pregnant women received the test during prenatal care, while the rest of the country there is a coverage of 63%.
The fragility 'of health systems and insufficient number of health care professionals, medicine and adequate equipment are the major obstacles for the dissemination and expansion of programs to prevent vertical transmission in the region. In addition, local communities are not always involved in planning and implementing programs.
At the regional level, funds to fight HIV / AIDS from donor countries have increased significantly in recent years, however, children have not yet received their fair share. UNICEF advocacy continues to do so that 'donors can invest more' programs for children, in this case the prevention of mother to child transmission, so that 'every child in the future with the right to be born healthy, without the risk of contracting HIV. BOX - How communication can 'reduce the risk of vertical transmission: the case of Ecuador
' s 0.3% of Ecuadorian women and 'HIV and 1,000 children are at risk of contracting the virus through vertical transmission. During the second half of 2006, the advertising agency 'Norlop JWT, together with UNICEF and the Ministry of Health, have developed a public communication campaign to spread awareness across the country to prevent vertical transmission and to encourage public perform HIV testing on a voluntary and confidential. An innovative commercials for radio and television has marked the sign: it shows a father who, while kissing the belly of his pregnant wife, and 'encouraged by his baby' in the belly to support the woman to get an HIV test. The initiative was strongly aware of the population by duplicating the number of HIV tests performed on pregnant women: from 7,132 in the first half 'of 2006 and' came to 12,656 in the second half '. This' can show that more 'than 50% of Ecuadorian pregnant women wanted to know more' about their health. It is estimated that 170 women in Ecuador are HIV-positive pregnant and that 148 of them receive antiretroviral treatment, thus reducing 'the number of Ecuadorian children who might have been born HIV positive. The case of 'Ecuador shows us how the alliance with the private sector and the media comunicaizone is an essential component for effective primary prevention.
Anna Berardi,
Assistant Programme Officer - HIV / AIDSUNICEF TACRO (The Americas and Caribbean Regional Office)
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