Despite many global initiatives, HIV continues to be a serious problem globally for people of all ages.

In its recent release, the United Nations Institute for Children Education Fund (UNICEF) made some shocking revelations about the rise in spread of HIV among young girls.

Around 30 teenagers aged 15-19 were newly infected with HIV per hour in 2017,” said UNICEF in its report titled ‘Women: At the Heart of the HIV Response for Children’ presented at the International AIDS Conference 2018 in Amsterdam.

The report that examined HIV and AIDS among the children and mothers found that “every three minutes, a teenage girl is infected by HIV”.

“HIV thrives among the most vulnerable and marginalized, leaving teenage girls at the center of the crisis,” UNICEF Executive Director Henrietta Fore said in a statement.

Key Findings
UNICEF notes that the increasing prevalence of HIV among adolescents is pulling back the global efforts taken over the years to tackle the epidemic.

“Adolescents continue to bear the brunt of the epidemic and that failure to reach them is slowing down the progress the world has made in the last two decades in tackling the AIDS epidemic,” adds UNICEF.

The report found:

• Adolescents between the ages of 10-19 years account for almost two-thirds of the 3 million
  population in the 0-19 age group suffering from HIV
• Even while deaths for all other age groups, including adults, have been decreasing since 2010, deaths among older adolescents (15-19) have seen no reduction.
• Around 1.2 million population in the age group of 15-19 years were living with HIV in 2017, with ‘three out of five of them being girls’.

The report noted that early sex and related issues, lack of proper counselling and testing services are among major factors leading to the spread of epidemic among girls.

We need to make girls and women secure enough economically that they don’t have to turn to sex work. We need to make sure they have the right information about how HIV is transmitted and how to protect themselves, Angelique Kidjo, UNICEF Goodwill Ambassador said in the report.

Addressing Concerns
In its report, UNICEF informed about its efforts in collaboration with UNAIDS and other partners over the period to tackle the epidemic.

Some of them include:

• All In to End Adolescent AIDS- A program that aims to reach adolescents in 25 priority countries that has the world’s highest adolescent population suffering from HIV.
• Start Free, Stay Free, AIDS Free– A special framework aimed at controlling the spread of HIV among adolescents and young women to less than 100,000 by 2020.
• The HIV Prevention 2020 Road Map– An action plan to expedite HIV prevention measures with key focus on structural barriers such as punitive laws and lack of adequate services, while also highlighting the role of communities in executing the measures.

As a result of these initiatives, UNICEF could achieve a drop in the number of new infections among children (in the age group of 0-4 years) by one-third during the 2010-17 period.

According to UNICEF, 4 out of 5 pregnant women with HIV are accessing treatment to keep them healthy and reduce the risk of transmission to their babies in the current scenario.

“Adolescent girls and young women are particularly impacted. Without effective prevention of HIV, they are likely to pass along the virus to their babies, continuing the cycle of infection to the next generation,” UNICEF adds.

“Women are the most affected by this epidemic – both in the number of infections and as chief caregivers for those with the disease – and should continue to be at the forefront of the fight against it,” Fore said in an ending note.

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The World Health Organization (WHO) validated this in its recent announcement calling this as a milestone achievement for the country. Nepal “becomes the first in WHO’s South-East Asia Region to defeat the world’s leading infectious cause of blindness”.

WHO South-East Asia Regional Director Dr Poonam Khetrapal Singh and WHO Director General Dr Tedros Adhanom Ghebreyesus in Geneva, Switzerland handed over an acknowledgment letter of validation to the Nepali Minister of State for Health and Population Padma Kumari Aryal as part of the World Health Assembly.

Applause for Governance

Officials had a round of applause on Nepal for this ground-breaking achievement of dealing out with the disease of concern.

The Government of Nepal involving the Minister of State for Health and Population, the Ministry of Water Supply and Sanitation and the Ministry of Education, supported by the strong commitment of local health workers and volunteers drew deserved focus for their efforts on this achievement.

Nepal’s Years of Efforts: An Example of Public-Govt Commitment

Nepal has really come a long way for finally dealing out with the world’s leading infectious cause of blindness. The struggle dates back to the 1980s when Trachoma was the second leading cause of preventable blindness in Nepal.

Stepping up the efforts, the Government of Nepal took a serious initiative in 2002 by establishing the national trachoma program for the complete elimination of the disease. As part of this effort supported by sustained control activities, the country could see the prevalence of active (inflammatory) trachoma fall by 40 percent during 2002-05.

Meanwhile, the Ministry of Education also proved its significant role in taking the program to the next level by spreading awareness across the nation while also proposing the inclusion of a module on trachoma in the school curriculum.

As part of control activities, the Ministry of Water Supply and Sanitation played crucial by supporting the local communities and districts with the necessary incentives required for building basic infrastructure facilities that improve sanitation and control disease-carrying flies.

The mission to fight trachoma also involved activities across the country.

• Nearly 30 000 operations were conducted to manage trichiasis
• More than 15 million doses of azithromycin were distributed with the help of NNJS supported by the United States Agency for International Development-funded ENVISION project implemented by RTI International under the International Trachoma Initiative
• Overall, the country saw the establishment of eye hospitals and dozens of eye centers and clinics with trained staff between 2002 and 2014

As a result, a series of health surveys conducted progressively during 2005-15 proved the falling rate of active trachoma in children below the elimination prevalence threshold. Low prevalence after the discontinuity of mass antibiotic treatment was also observed.

Global Efforts

The efforts to fight trachoma took a serious turn in 1998 when the World Health Assembly resolved to eliminate trachoma as a public health problem globally.

Since then, the world nations began striving for significant progress in this path and an increasing number of endemic countries eventu

ally started meeting targets for national elimination of trachoma as a public health problem.

WHO has been in the forefront in taking ahead the initiative on a global scale. As part of its efforts, WHO launched the WHO Alliance for the Global Elimination of Trachoma by 2020 (GET 2020).

Under this initiative, WHO stepped up efforts to support country-wise implementation of the SAFE (Surgery for trichiasis, Antibiotics to clear infection, Facial cleanliness and Environmental improvement to limit transmission) strategy and strengthening of national capacity through epidemiological assessment, monitoring, surveillance, project evaluation and resource mobilization.

Significant Events in Nepal’s Fight Against Trachoma from 1978 to 2018

Source: WHO South-East Asia

In 2014, Dr. Khetrapal Singh identified the elimination of neglected tropical diseases as one of the flagship priority programmes across the globe. As a result, the countries in the region including Nepal continued their concerted efforts and Nepal eventually emerged as the first one in the region to fully eliminate the disease nationwide.

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In a move enhancing healthcare facilities across the region, the South Asian Association for Regional Cooperation (SAARC) Surgical Care Society (SCC) announced plans to construct three hospitals, one each in India, Pakistan and Nepal.

Under this plan, announced at a conference held in Ludhiana yesterday, the three hospitals will provide free surgeries with the support of SAARC SCC.

According to the President of SAARC SCC and Principal of Lahore Medical and Dental College Dr A Majeed Chaudhary and Laparoscopic Surgeon Dr Arbar Ashraf Ali, the plans in this regard are currently under process.

“The treatment for liver transplant and pediatric cardiac medical facilities and infrastructure are not up to the mark. Many children with holes in heart travel to India. As far as other ailments are concerned, Pakistan and India are at the same level,” said Dr Chaudhary.

Under SAARC, this will be beneficial as each country is best in some field or the other, he added.

The organizers expressed hope that the project would strengthen ties among all the nations.

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