After nearly forty years of tireless activism, advocacy, funding, and research to prevent and treat HIV/AIDS, it is no longer the devastating death sentence it once was. Many people are living longer with the disease, many HIV-positive mothers are not passing on the disease to their babies, and millions of adolescents are learning how to prevent HIV infection. It is only appropriate that we celebrate these life-saving and life-altering milestones. But we must also be candid about where progress is lagging.

Children and adolescents are the group for whom HIV infection is actually on the rise. More than 400 new infections in children happen globally every single day. In sub-Saharan Africa, AIDS is the leading cause of death for adolescents.

Many of these children and adolescents are outside of the reach of conventional programming. They are too poor, too socially excluded, or too far away from services or treatment. They include children from ethnic and religious minorities; children with disabilities; children who have lost one or both parents; or children whose parents are sex workers or drug users. Their needs will not be met, nor will the disease be eliminated, without changing how we operate.

Reaching all children requires new approaches. We have to go beyond the biomedical. We must remove the social and economic barriers between these excluded children and the HIV/AIDS services they most ardently need. And we must build their resilience and that of their families to overcome the effects of the epidemic.

Social protection—such as cash/in-kind transfers, social insurance, and social services—is vital in this regard. It has already proven to reduce the risk of HIV infection. And anecdotal evidence—such as that which was provided in these 2018 UNICEF policy briefs and discussed during this webinar—suggests that communities most impacted by the epidemic have long provided extremely vulnerable children and their families with a range of social protection supports alongside HIV services.

However, there is limited documented evidence to show how social protection helps children to be tested, treated, and cared for. Without having available funds, community-based organizations are not able to document or share innovative practices. Meanwhile, the impact of social protection has not been fully evaluated by scientists monitoring large numbers of children and communities affected by HIV and AIDS. This lack of evidence is holding back investment in solutions that work. Without it, people making decisions on global policy, programming, and funding remain unaware of what works and unable to deliver it at scale.

ViiV Healthcare and the Coalition for Children Affected by AIDS recently launched a new Positive Action Challenge—Reaching All Children—to help build this evidence base. Funder members of the coalition include the Conrad N. Hilton Foundation, among others. The Reaching All Children Challenge will shine a spotlight on scientific findings and case studies and drive greater attention toward proven models of using social protection programming to reach children and adolescents affected by HIV. Organizations or researchers who can demonstrate how social protection can lead to increased HIV testing and treatment among children are encouraged to apply. Learn more on the Reaching All Children webpage.

The success we’ve experienced in the fight against HIV so far has been possible because the first generation of activists and advocates experienced the problems, envisioned innovative solutions, and, most importantly, took action. We can apply those learnings to reach those now being left behind. We must uncover the evidence, make it known, and catalyze change.

There is no reason we cannot reach all children affected by HIV and AIDS.

Read more in this brief.

Author: Corinna Csaky, Jennifer Carpenter

Source: https://www.healthaffairs.org/do/10.1377/hblog20181226.352506/full/