Zahira Kharsany interviews DAVID ALNWICK, UNICEF HIV Advisor

JOHANNESBURG, Dec 1 2008 (IPS) – According to the United Nations Children s Fund, early diagnosis and treatment greatly increase survival rates for HIV-positive newborns. but fewer than one in ten infants born to HIV-positive mothers in 2007 was tested for HIV within two months of birth.
Children and Aids: Third Stocktaking Report 2008 , released by the United Nations Children s Fund on World AIDS Day, warns that without the right treatment, half of children with HIV will die before their second birthday.

The UNICEF report focuses on what is known as the four Ps . These are the prevention of mother-to-child transmission of HIV, providing pediatric treatment and care, preventing infection among adolescents and young people, and protection and care of children affected by AIDS.

UNICEF Regional HIV Advisor for east and southern Africa, David Alnwick, discussed the findings of the report in these key areas with IPS reporter Zahira Kharsany.

IPS: What has the outcome been?

David Alnwick: Progress! Progress has been slow with implementing key priorities, particularly preventing infants born to mothers with HIV from becoming infected themselves. But many countries have done really well in last year or so on this.
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In East and Southern Africa about 30 percent of all pregnant women get an HIV test and if positive, most get some help to prevent transmission. About half of all health centres provide routine HIV tests to pregnant women. This is far from good enough but it does represent real progress, a doubling over the last few years, and hopefully it will double again in the next year.

Also there have been new scientific breakthroughs on children who are infected, in spite of efforts to prevent and many countries despite big obstacles are now rolling out early infant diagnosis , testing kids for the virus at six weeks of age, and putting them on treatment immediately if infected. These are good beginnings, but needs a lot more support.

IPS: What needs to be done?

DA: We need to break the cycle of transmission. We ve been concentrating on aid prevention in general but especially prevention in women and girls. The report takes stock of countries and we at UNICEF are optimistic that good progress is being made.

But still only one third of all women are tested for HIV. This is not good but it is a lot better then before. It means that countries and governments are taking it seriously. There are optimistic signs that there is progress.

UNICEF has good hopes that effective services for mums already infected will be rapidly scaled up and that children will be protected to maximum extent possible, and where not possible, helped with treatment.

IPS: What concerns are there?

DA: UNICEF is very concerned in East and Southern Africa about the lack of progress with primary prevention of HIV infection, particularly in young women around the time that they become pregnant. This needs much more emphasis, much more radical approaches, much more government support at highest level. We are seeing these signs but much more can be done to prevent HIV infection in girls and women in southern Africa.

Our biggest concern is that even though there has been an increase in prevention from mother-to-child the tap is not being turned off. The infection in women and girls is not lowering. We hope that things will become better with improved medical technologies and government assistant. But we ve got to do more. It s not only the job of UNICEF, but all non-governmental organisations, civil society and governments to do more.

IPS: There s a new emphasis amongst AIDS campaigners on knowing your epidemic , that is to say analysing the local situation in terms of who is infected and what factors are driving the epidemic, and then acting on this information. How does UNICEF view this approach?

DA: Yes we fully support need to know the epidemic . The days for generalised approaches are over.

The intriguing thing in southern Africa is that the evidence is clear that it is not just poor or un-educated girls who are infected. In fact women in southern Africa are according to the World Economic Forum among the most empowered women on the continent. We need to ask ourselves is, what is happening that young women in Southern Africa have used this relative empowerment, this relative freedom, wealth, mobility, to practice sex lives that are now becoming as risky as men s sex lives have been for many years, that is several different sex partners at same time for example.

It is not the lack of empowerment that these women and girls are infected. Statistics show that those that are infected are now the educated ones with disposable incomes. The old story of it being those who are poor and live in poverty and have to sell themselves to make some money is not true. It is those who are educated that are becoming infected. I for one believe that we need to look at the process. The most empowered are the ones most at risk. We must ask ourselves why this is so.