Global efforts to control HIV transmission may be showing good results, but the target set to reduce infections among children has taken a severe hit, data released by UNAIDS shows. 

Governments agreed to reduce infections among children in the age group of 0-14 years to 20,000 by 2020. However, estimates show 150,000 children were newly infected with the virus in 2019, four times the 2018 target. 

"To see so many tools available, so many new HIV infections among children that have been prevented, so many children living with HIV doing well, but to see others missed and still left behind is a tragedy," said Winnie Byanyima, executive director, UNAIDS. 

"We cannot accept that tens of thousands of children still become infected with HIV and die from AIDS-related illnesses every year," she added.

In order to meet the target, countries focused on providing antiretroviral (ART) medicine – an HIV therapy – to pregnant women from pregnancy, to delivery and also throughout the breastfeeding period. The intervention is known to drastically reduce the chances of mother to child transmission of the virus to less than one percent. 

While more than 85 percent of pregnant women living with the virus received the therapy, a significant number of children still got infected.  

The UNAIDs report titled "Progress towards the Start Free, Stay Free, AIDS Free targets 2020," cited unequal access to treatment services, primarily in western and central Africa, resulting in a spike in new cases.

Only a little over half or 950,000 children of 1.8 million children living with the infection in the target age range of 0-14 years received antiretroviral therapy as of December 2019, up from 860,000 in 2015, but missing the target of 1.4 million by 2020. 

Marginal gains

In the 21 focus countries, the number of children receiving the ART treatment climbed to 770,000 by the end of last year, but the increase was marginal from 710,000 in 2015. 

"The world has failed to diagnose and start treatment for almost half the children living with HIV," said the report. 

Globally, new HIV infection came down by 23 percent, with nearly 1.7 million new HIV infections reported in 2019, missing the target of 75 percent.

The number of infections has significantly reduced in eastern and southern Africa, but it grew by about 20 percent in the last decade in Latin America, the Middle East and North Africa. 

HIV, which causes AIDS, has been termed a pandemic by a section of researchers. It claimed 690,000 lives in 2019.  

"As a global community, we have made remarkable progress toward controlling the HIV pandemic, yet we are still missing far too many children, adolescents and young women," said Angeli Achrekar, principal deputy, United States Global AIDS coordinator, United States President's Emergency Plan for AIDS Relief.

Caught between two pandemics

But with the novel coronavirus overwhelming and disrupting the health systems, pregnant women and children living with HIV would face a tough time accessing ART therapy, the UNAIDS and the WHO warned.

Various studies based on modeling estimate that if the supply of antiretroviral drugs is disrupted for six months for 50 percent of pregnant women living with HIV, this could lead to an additional 67,000 children acquiring HIV in sub-Saharan Africa. A three-month disruption in Malawi would lead to a 25-percent increase in the number of newly infected children.

More than 24 countries are experiencing shortages of ART, which controls the virus, preventing sexual transmission to other people. With global supply routes disrupted by lockdowns affecting air and surface transportation, aid agencies are struggling to procure the ART consignments.

The COVID-19-related disruptions to health systems, community and social services and economies threaten the gains achieved under the AIDS prevention framework and require urgent action to sustain and accelerate progress towards the global targets, wrote the report.

"We can do better. We must do better," added Byanyima. "We know how to save lives and stop new HIV infections among children. I demand that we spare no effort. Anything less is shameful," Byanyima added.  

(Cover: Nepalese women and children from  "Maiti Nepal," a rehabilitation center for victims of sex trafficking, light candles on the eve of World AIDS Day in Kathmandu, Nepal, November 30, 2015. /AP)