HIV infection is one of the most challenging diseases. FILE PHOTO | NMG
The Acquired Immunodeficiency Syndrome (Aids) epidemic is now in
its fourth decade after the initial description of Human
Immunodeficiency Virus (HIV), in 1983.
At the
beginning of the epidemic, HIV was invariably fatal. With the
availability of antiretroviral therapy (ART), it has now become a
chronic treatable condition in children, as well as in adults.
Though
concerted efforts have resulted in reduction in new cases there are
currently about 36 million people estimated to be living with HIV
worldwide. An estimated 78 million people have become infected with HIV
and 35 million people have died of Aids-related illnesses since the
start of the epidemic.
Approximately 19.5 million
people were accessing antiretroviral therapy by 2016. These global
efforts have meant that the number of people receiving HIV treatment has
increased dramatically in recent years, particularly in resource-poor
countries.
This has resulted in more HIV infected people with increased
exposure to unborn children. A great stride has also been made in the
area of prevention of mother to child transmission (PMTCT) of HIV with
significant reduction in new paediatric cases.
HIV
infection, especially in children, is a family disease with social,
economic and medical aspects that make it one of the most challenging
diseases in the current times. The virus can be very well controlled
with good quality of life, but so far there has not been a cure and
life-long treatment is required.
The most significant
shortcoming in the response to paediatric HIV remains the limited
prevention of mother-to-child transmission (PMTCT). In the developed
countries, mother-to-child transmission has been virtually eliminated.
By
law, children around the world are protected from preventable disease
and death. In Kenya, every child is guaranteed the right to health by
virtue of international treaties and the constitution. The law is clear,
but the implementation remains a challenge and HIV/Aids continues to
kill children.
The Kenya Demographic Health Survey
(KDHS), carried out in 2008/2009 estimated that 1.49 million Kenyan
adult and children were infected with HIV out of which 110,000 were
children aged 0-14 years.
HIV/Aids present the
greatest challenge to the development of any country and has puts
immense pressure in the workplaces. The bulk of the infection is in the
productive age-group (25-49years).
This has resulted
in Kenya instituting polices that would help organisations handle
HIV/Aids infected persons with more respect and reduced stigmatisation
and victimisation.
A person can still continue working
even when diagnosed with HIV without fear of being laid off on the basis
of their HIV status.
About 15 women die every day due
to pregnancy-related complications in Kenya and 20 per cent of all
deaths among mothers in the country are HIV/ AIDS related.
In
2003, there were 650,000 Aids orphans in Kenya. In 2008, the Government
began providing free antiretroviral drugs (ARVs) to HIV-positive people
who need them, and medical care is now free for children under five.
There
has been progressive increase in HIV testing facilities in Kenya. In
2000, there were just three voluntary counselling and testing (VCT)
sites but this had increased to more than 4,000 by 2010. In 2008, about
860,000 people were being tested annually for HIV and in 2013 had
increased to 6.4 million.
From 2009 to 2013, the percentage of pregnant women tested for HIV increased from 68 per cent to 92 per cent.
Kenya
has made big steps towards creation of “Aids-free generation”. In
partnership with USAid, the Government of Kenya has enabled the country
to combat the HIV/Aids epidemic.
Kenyans have
increased access to HIV/Aids prevention, treatment and care services,
more people are on anti-retroviral therapy and more Kenyans are being
tested for HIV.
Kenya is among those nations in which
significant progress has been made, both in preventing mother-to-child
transmission and in testing and treating infants and other children.
By
2011, 69 per cent of the pregnant women with HIV received ARV drugs to
prevent mother-to-child transmission, 2,340 health facilities provided
early infant diagnosis for HIV and over 31 per cent of children needing
antiretroviral treatment were receiving it.
This is an
excellent illustration of how international law, national policy, and
public health programs can mutually reinforce the realisation of the
right to health.
Wahu Gitakah is Consultant Paediatrician at Aga Khan University Hospital.
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