Renewed action needed to end HIV among children in West and Central Africa
18 January 2019 – A new “Dakar Call to Action”, which aims to achieve rapid progress in reducing new HIV infections and deaths among children and adolescents, was signed today by public health leaders, ministries of health, and representatives from partnering agencies from 18 countries in West and Central Africa.
"We should not lose any more of Africa’s future to AIDS,” said WHO Regional Director for Africa Dr Matshidiso Moeti, who opened the event.
The West and Central African subregion is home to nearly 800 000 children and adolescents living with HIV, according to 2017 data. During that year, around 67 000 children (aged 0–9 years) and 69 000 adolescents (aged 10–19 years) became newly infected with HIV.
The subregion is facing the highest levels of HIV transmissions from mother to child in the world, with rates above 20% observed in 13 countries. Low rates of HIV treatment among pregnant women and children born with HIV have led to the crisis.
Despite challenges, rapid progress is possible, as demonstrated by a number of national programmes. Within the subregion, 21 countries are implementing WHO’s “treat all” policies. Cabo Verde and Burkina Faso have achieved around 90% HIV treatment coverage for pregnant women. And countries such as Côte d’Ivoire have nearly tripled the number of people accessing HIV antiretroviral therapy between 2010 and 2017.
However, serious challenges persist, as highlighted by Dr Moeti in her statement. “Diagnosis and treatment of children living with HIV is a major challenge. It is unacceptable that only 1 in 4 children living with HIV have access to treatment,” she said. “Most of the children with HIV are receiving suboptimal treatment regimens. This is a particular concern in the subregion, where drug resistance rates are reaching over 60% in some areas, with only 30% of people on treatment successfully achieving viral suppression.”
Dr Moeti also highlighted the special attention needed to increase HIV services among adolescents, particularly adolescent girls, who are most affected by HIV in the subregion. “This is part of the reason why I made adolescent health a priority in the African Region,” she said.
The event, co-organized by WHO, the Joint United Nations Programme on HIV/AIDS, the United Nations Children’s Fund and national governments concluded with the renewed “Dakar Call to Action”, a follow-up on the previous statement issued in 2015.
This document urges regional leaders to mobilize high-level political commitments and leadership to expand quality services for HIV-positive mothers, pregnant women, children and adolescents, as part of the overall effort to build sustainable health systems and enable healthier future generations in West and Central Africa.
The document also urges countries to adopt WHO’s recent recommendations to “treat all” patients with HIV and implement more effective HIV treatments, including innovative diagnosis and testing services, through more decentralized service delivery.