By Rev. Msgr. Robert J. Vitillo, Head of Delegation to the UN in Geneva and Special Advisor on HIV/AIDS for Caritas Internationalis
Let’s begin with the good news - of a child who gained access to anti-retroviral treatment (ART) at the Village of Hope, a programme in Tanzania that is assisted by the Vatican’s Bambino Gesù Hospital. However, there are other tragic experiences, too numerous to tell, of children who are diagnosed too late to benefit from such treatment.
Despite World Health Organisation (WHO) recommendations to test all infants with unknown HIV exposure and to start treatment for all HIV-infected infants under 12 months of age, access is still a grave problem in many parts of the world.
For example, in Myanmar, ART is available to only 1/3 of adults who need it, and there are no reliable estimates of infected children, let alone of those who need ART. In fact, in that country, Caritas and other faith-based organisations (FBOs) still struggle to obtain preventative medications for opportunistic infections.
Pharmaceutical companies deserve recognition for having developed fixed-dose combinations (FDCs), some of which are available at affordable prices. However, more effort must be placed on developing appropriate affordable formulations for second and third-line treatment regimens.
Caritas partner, Fr. John Toai, of Vietnam, tells us that that most HIV/TB co-infected children at his Mai Tam Centre are forced to takes 9- 12 tablets per day. Often, these children are unable to eat after taking the medicines. The pills are hard to swallow and several side effects are reported. Some of these children cannot access paediatric dosages. According to Fr. Toai, attempts to cut up pills meant for adult use often result in under- or over-dosing.
In our attempts to simplify medication regimens, we need to address multiple infections, not only HIV … and then there is the need for food.
HIV testing and treatment is vital, but we can no longer maintain a “silo” approach to paediatric HIV care – we need integrated management of HIV, TB, and other opportunistic infections and point of service accessibility of testing and treatment. We also need to assure adequate nutrition and eliminate stigma and discrimination toward children who are living with or affected by HIV.
Access to medicines is a fundamental element of the child’s right to health under article 24 of the Convention on the Rights of the Child.
Caritas believes that governmental and political leaders, private enterprises, and civil society should account to the children of the world on how they have fulfilled their responsibility to promote and respect this right. We need to build up a global movement to ensure that all children living with HIV can be diagnosed early and then can be afforded access to the life- saving treatment that they so desperately need in order to live beyond their first or second birthday.
Caritas Internationalis, the Association of Pope John XXIII, and other Catholic Church-related organisations have been encouraging the UN Human Rights Council to adopt more focused and effective advocacy for the child’s right to health.
Caritas HAART for Children Campaign
- To Scale up PMTCT (Prevention of Mother-to-Child Transmission of HIV
- To Increase Development and Access of Paediatric Testing for both HIV and TB
- To Increase Development of Paediatric Treatment for HIV and HIV/TB Co-infection
One way in which Caritas is attempting to fulfil this responsibility to promote Universal Access is through its HAART for Children Campaign that targets pharmaceutical companies, governments, and other policy- and decision-makers to increase development of and access to Paediatric “child-friendly” testing and treatment for HIV and TB.
The goal is to save the lives of the 800 children who die each day from AIDS-related illnesses and to eliminate mother-to-child transmission of HIV by increasing access to and uptake of effective programmes for mothers who are living with HIV.
Caritas cooperates with the Ecumenical Advocacy Alliance and other faith-based organizations to achieve the goals of this Campaign. At the International AIDS Conference in Vienna, for example, Caritas Austrian delivered 20,000 Campaign signatures to the officials of the Austrian Foreign Ministry.
The Religious Brothers of the Edmund Rice Institute and the International Young Catholic Students have encouraged more than 1,000 students to write letters. Caritas India is training social work students to assess and report on access to child-friendly medicines in local communities.
Whenever I travel to Vietnam, I spend time at Fr. John’s Mai Tam Centre. Many of the children have arrived at the shelter too late to benefit from ART. I have held some of these children when their little bodies were burning with fever and their death was expected imminently.
Now, as a result of early diagnosis and careful treatment with anti-retroviral and TB medicines, the smiles of other children at the shelter give excellent witness to the benefits of HAART for children.
With your help, may our Caritas campaign be successful in bringing such smiles to the faces of many more HIV-positive children in all parts of the world.
This entry was based on a presentation at “Faith-based Action to Achieve Universal Access” side event at UN High Level Meeting on AIDS 8 June 2011 in New York.