Only half of children living with HIV receive ART globally, experts say

Only half of children living with HIV receive ART globally, experts say

Dec 10, 2020 Our Blog by admin
A package of ARVs. Photo: WON.

By Mike Mwaniki

At only three years, Naomi Wangui who is living with HIV, faces an uphill task while taking her ARVs which she describes as “bitter with a very unpleasant taste”.

The child—who was born with HIV in Nairobi—is among half of the children aged below 15 years living with HIV who are receiving antiretroviral therapy globally, says a leading scientist. 

Dr Irene Mukui—who is the HIV Access and Medical Affairs leader (DNDi Africa regional office) has revealed that in 2019 over 300 children (aged 0 to 14 years) and adolescents died every day from AIDS-related causes while about 400 children were infected with HIV daily globally.

Low access to antiretroviral treatment, in addition to limited prevention efforts, Dr Mukui notes, is one of the leading causes of these deaths.

According to Dr Mukui, new HIV infections among the children (0 to 14 years) in 2019 were estimated at 150,000 while deaths due to AIDS in the same period were estimated at 95,000.

“Currently, 90 per cent of HIV infections occur through mother to child transmission with 90 per cent of paediatric infections occurring in sub-Saharan Africa,” Dr Mukui noted.

Dr Mukui, warns that without diagnosis and treatment, 50 per cent of HIV-infected infants will die before their second birthday,

At the same time, Dr Mukui described treatment for children as “complicated” as it requires a combination of pills or liquids with some that can be difficult to swallow or have unpleasant taste.

“However, in 2020 and early 2021, we expect two new formulations to be approved. Dolutegravir 10 mgs dispersible tablets-as preferred drug recommended by the World Health Organisation in combination with others.

She said there is no combination of three drugs recommended by WHO for first line treatment for children.

Children, Dr Mukui observes, have less access to HIV testing and treatment.

“Currently, only half of HIV infected children less than 15 years are receiving antiretroviral therapy. “The paediatric ARV market is particularly vulnerable and complex because children are few and they require different dosages and formulations as they gain weight,” she said.

HIV diagnosis testing for children needs to be more affordable and available to children.

“Medicines specifically adapted to the needs of children need to be developed and kept at an affordable price,” the medic added. 

According to Dr Mukui, a majority of the 1.8 million children aged 15 years and below globally who are living with HIV are in East and Southern Africa.

“Six in 10 HIV exposed babies are tested for HIV within their first two months of life. Early infant diagnosis improves their survival. However, access to HIV testing for infants and children remains poor in many African countries,” she added.

The National Aids and STIs Control Programme (NASCOP) Head, Dr Catherine Ngugi says children are disproportionately affected due to unfavourable treatment formulations, which are intolerable to them.

“The government is now investing more in innovative testing approaches such as self-testing. Infants born to HIV-infected mothers now have access to prompt HIV diagnosis and treatment,” she noted.

Although NASCOP statistics indicate the number of children living with HIV has reduced from 191,840 to 106,000 between 2015 and 2020, Dr Ngugi is concerned that if the disease is ignored as all interventions are directed at Covid-19, the country will be sitting on a “ticking time bomb”.

“We need to address the needs of children living with HIV, especially during this pandemic,”.

According to WHO, without access to testing and treatment, 50 per cent of children with HIV will die by the age of two, and 80 per cent will not live to their fifth birthday.

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