Category Archives: HAART for Children

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.

On the way to the International AIDS conference centre in Vienna the underground fills up with more and more people, not surprising as there are supposedly 25,000 participants.

Somehow New York, as one of the most multicultural cities I’ve been too, comes into my mind. Today Vienna experiences an even bigger mix of nationalities.

Queuing for the entrance people approach me with a big sign that says “FREE HUG”. Not easy with the photo equipment backpack I am carrying. Tons of hugs are exchanged before the conference on Sunday evening officially starts.

At the conference there is one building for public access called the ‘GLOBAL VILLAGE’. It was supposed to open on Sunday at 5 pm only. But due to strong interest of the general public it had to open at noon.

One of the main topics we hear about at the plenary session that first night, is that the world needs to provide pregnant women living with HIV access to simple, inexpensive medicines that will prevent the transmission of the virus from mother to child.

In Europe and the United States, the rate of infection of children at their birth could be reduced to a mere 1%, while there are still parts of this world where up to one-third of children born to HIV-positive women are themselves infected with the virus.

As child-friendly HIV tests and medication are still missing, up to 50% of those children die before their second birthday.

The development of child-friendly medication is a Caritas concern. For this reason,  the “HAART for Children” campaign was launched in 2009.

An important event organised by CARITAS in the GLOBAL VILLAGE of the conference took place on Monday. So I decide to have a look around the GLOBAL VILLAGE Monday afternoon and to attend to some sessions there.

Many organizations show their activities in the field of HIV and AIDS.

Suddenly a puppet wants to kiss me. I would have loved to see my face at that moment.

The No Strings Campaign

The puppet belongs to NOSTRINGS – Life-Saving Lessons through the Magic of Puppetry, a programme supported by the Irish Caritas (Trócaire). I decide to watch one of their short films on stigmatisation of people living with HIV and AIDS. The protagonists of the film are puppets and those short films are showed around the world in order to spread information about HIV. Great idea, I can see children love it. Not just children by the way.

Then I attend to a session called: ‘Left at the maternity hospital – Children and HIV in Eastern Europe’ which takes place in the GLOBAL VILLAGE. Caritas specialists from Ukraine and Russia share their experience in working with children affected by HIV/Aids and present challenges and good practices in supporting children having been left after birth or growing up in stigmatized families affected by HIV, dealing with drug addicted parents or living at high risk on the streets. The audience is primarily interested in getting as much information as possible on concrete programmes Caritas is running and good practice.

So, now it’s time to meet some journalists which are going to report on one of the main event of Caritas at the conference in their advocacy for child-friendly medicine.

Different experts such as Ronita Mahilal from South Africa and Rev. Msgr. Robert Vitillo talk about challenges in working with HIV positive children, about  possibilities and limitations in treatment.

Together with young people from Austria, Slovenia and Slovakia, Caritas President Franz Kueberl hands over 21.626 signatures collected by Austrian young people to Irene Freudenschuss-Reichl (Director-General for Development Cooperation, Foreign Ministry, Austria).

Besides good and informative speeches, young people from Vorarlberg – which were strongly involved in getting signatures – dance and present a video, their message is: “HAVE A HAART FOR CHILDREN”

“Now governments and pharmaceutical companies have to show if they have a heart”, one of the participants tells me.

Discussions and events on Tuesday and Wednesday focus a lot on how to make programmes more efficient. Efficiency is one of the big words at the conference, also used by Bill Clinton in his speech.

Another important topic heavily discussed at the conference is flat-lining and reductions of financing of programs.

“For years they told us to upscale medication programs, now they suddenly tell us to downgrade. What they don’t tell us from Global Fund and PEPFA is how to do that. So every day I have to decide whom to give medicine and whom not,” said Fr. Richard Bauer, Director of Catholic AIDS Action of Namibia, which serves more than 14,000  AIDS orphans and many people living with the virus.