More than 4,000 babies were born with HIV in 2023 in Kenya, despite the availability of free medication aimed at preventing mother-to-child transmission. Still, two out of every ten of these children born with HIV are not receiving the life-saving ARV drugs.
The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), a non-profit with offices in Kenya, is working with the Ministry of Health to end HIV/Aids in children, youth, and families. RHODA IGWETA, the Egpaf Regional Director for Public Policy & Advocacy, spoke to Star’s John Muchangi about the advances being made.
What are the current policy
priorities for the Elizabeth Glaser Pediatric AIDS Foundation, particularly in
Sub-Saharan Africa?
We have 4
focus areas that we are working on with policymakers to pave the way to the end
of pediatric AIDS.
1) Scale up HIV prevention services so the next generation of mothers and fathers are HIV-free and can raise HIV-free families.
2) Expand innovative testing approaches to find the children who are living with HIV and get them on treatment as soon as possible.
3) Use community-based interventions to reach new and expectant mothers and their children with care, treatment and support close to where they live.
4) Integrate more health services into HIV service delivery, strengthening the overall health system to ensure the long-term survival of children and families affected by HIV.
Sustainable
international and domestic funding for HIV programming will be crucial to
accelerating progress on pediatric HIV. But more importantly, more we need more
African leaders to step forward and make ending pediatric AIDS a national and
continental priority throughout Africa, since almost 90% of the world’s
children living with HIV reside in Africa.
EGPAF remains focused on addressing the inequity that children in accessing health services wherever we work. Learning from what we see in the HIV response, there is so much progress in attaining the 95 95 95 targets for adults but less so when it comes to children. Our experience has shown us the same thing when it comes to Childhood TB which is harder to diagnose and therefore harder to treat.
Given this context, we are focused on advocating for policies that will address the inequities in the broader child health sphere so that we can ensure better outcomes for children living with and at risk for HIV. In addition to working directly with ministries of Health through Technical Working Groups to drive policy change and implementation that continues to keep children on the map, we are also engaged continentally in pushing for triple elimination efforts as these issues are closely interrelated but always keeping our mission at the core of our work to end AIDS in children.
What are the key challenges in eliminating pediatric HIV in Kenya and other parts of the global south?
We
have to contextualize and highlight that by looking at the global numbers. Almost
300 children are infected with HIV each day, and children living with HIV are
the age group least likely to access life-saving treatment. Nearly 90% of those
children are in Africa. Looking at Kenya, there were approximately 75,000 children aged
0–14 living with HIV in Kenya and more than 4000 new infections in
children in 2023.
The
first challenge is finding pregnant mums who are living with HIV to put them on
treatment but this is not possible if they only come to antenatal care late in
pregnancy or not at all which then increases the risk of transmission of the
virus. The other issue is that despite the availability of interventions, many
mothers lack access to effective antiretroviral therapy (ART) during pregnancy
and breastfeeding which again presents a risk for infections.
Further, we see that many infants
who are exposed to HIV are not tested early due to a lack of point-of-care
diagnostic tools and inadequate follow-up systems. Without a diagnosis, these
children will not be initiated on treatment. 82% of Kenyan children living with
HIV receive antiretroviral therapy (ART) which is progress but we need to make
sure that we find all the
children and put them on treatment. Homa Bay County has the highest burden of
pediatric HIV in Kenya, with over 10,000 HIV-positive children which is one of
the reasons we continue to remain focused on ensuring that these challenges are
addressed in this county and across the country.
Rhoda Igweta, the Egpaf Regional Director for Public Policy & Advocacy
One of the commitments that the government has made is through Kenya's plan to end AIDS in children by 2027 has four main strategies:
· End mother-to-child transmission: Stop the transmission of HIV, syphilis, and hepatitis from mother-to-child.
· Address the triple threat: Focus on the triple threat of new HIV infections, pregnancies, and sexual and gender-based violence among young people.
· Ensure children's voices are heard: Make sure children's voices are heard in the plan.
· Ensure no child is infected with HIV: Set a goal of no child being infected with HIV by 2027.
The
plan also includes strategies to:
· Mobilize stakeholders to reduce pregnancies, eliminate violence, and prevent new HIV infections.
There is new research by the Coalition for Children affected by
AIDS that reveals that the
largest gaps are in pediatric testing and treatment, economic support, and key
populations under age 18. This research was conducted in 3 countries that are
heavily reliant on PEPFAR for HIV funding similar to Kenya and shows the
amounts that are necessary to address the gaps. The research has
recommendations about how we can achieve more by investing wisely with the
funds we have to find and treat the many undiagnosed children living with HIV;
integrating HIV prevention, testing, and treatment services with broader
health, social and economic interventions to maximize efficiency, share costs
and achieve the greatest return on investment; refocusing funds towards the community-based
provision and leveraging their networks to reach excluded populations; putting
communities in the driver’s seat for funding decisions; improving donor
coordination and targeting; and growing domestic resources.
We are structured to work with
Ministries of Health and with national governments directly to support HIV
programs and always work closely with other organizations in consortia, through
grants and projects as well as to jointly drive advocacy.
Investing in the areas listed under Kenya's plan to end AIDS in children by 2027 and continental and global commitments to end HIV including the 95 95 95 targets is critical. We have to consider doing better actions to integrate to reach children at all points where they get services but remember that we cannot succeed without the involvement of communities who are front and center of the HIV response.
Are there any recent innovations
(eg pediatric drugs) or interventions that you believe could revolutionize
pediatric HIV treatment and prevention?