Pediatric HIV/AIDS ‘Preventable Tragedy,’ Opinion Piece Says
"The revolution of our generation -- this generation -- is to create a generation free of HIV," Pamela Barnes, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation, and Nicholas Hellmann, executive vice president of medical and scientific affairs for the foundation, write in a Globe and Mail opinion piece. "Imagine if we had a safe, effective, inexpensive vaccine for a deadly disease but we didn't use it," they write, adding, "Now imagine that reality for more than a million HIV-infected pregnant women each year and their HIV-infected children, who face a high probability of serious illness and early death." According to Barnes and Hellmann, 1,000 new pediatric HIV cases occur daily worldwide -- with 90% of the new cases occurring in sub-Saharan Africa -- and more than 700 children die from AIDS-related causes daily. They add that the main cause of pediatric HIV is mother-to-child transmission, and without early treatment, about 50% of infants living with HIV will die before age two. Barnes and Hellmann write, "This is an unimaginable, astonishing and entirely preventable tragedy."
In sub-Saharan Africa, the foundation has utilized "what is called PMTCT, or Prevention of Mother-to-Child Transmission," the authors write, adding that PMTCT is the "drug equivalent of a vaccine." In addition, PMTCT is "[i]nexpensive" and "relatively simple to administer" and can "reliably prevent most transmissions of HIV from a mother to her infant," according to Barnes and Hellmann. Although use of PMTCT in the U.S. has decreased the number of pediatric HIV cases to between 100 and 200 annually, almost 370,000 new cases occurred in the developing world in 2007, the authors write, adding that 270,000 children died of AIDS-related illnesses in the same year, more than two million children are living with HIV worldwide and about two-thirds of women in low- and middle-income countries do not have access to PMTCT. "This is an astonishing failure not of science, but of implementation," they write, adding that PMTCT is a "method tantamount to a vaccine" that "remains inexplicably underresourced and underutilized."
Although there has been "significant progress" in expanding access to PMTCT in developing countries, "dramatic scale up of PMTCT programs in the areas hardest hit by HIV and AIDS is still desperately needed," they continue. "HIV prevention, diagnosis, care and treatment should be integrated with other public health interventions," they write. "To succeed, we must work together with organizations and partners to maximize the impact of dollars spent and to develop more innovative solutions customized to local settings," the authors write, adding that success depends on "mak[ing] proven prevention methods available to everyone who needs them." Additionally, Barnes and Hellmann write that coordination between "contributors, implementers and countries facing this pandemic" needs to be promoted "to build the scalable and sustainable health programs that will stop this devastation in its tracks." They conclude, "Every day, together, we must commit to achieving a generation free of HIV. This is the revolution of our generation, a revolution we must fight for those who follow behind us" (Barnes/Hellmann, Globe and Mail, 2/9).