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We have a responsibility to save children

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By WERNER SCHULTNIK
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By ANYANG NYONG’O
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Today, we celebrate World Aids Day, an opportunity for all people to unite in the fight against HIV, to show support for people living with HIV and to commemorate those who have died from an Aids-related illness.

In Kenya, there has been tremendous progress in reducing the number of new HIV infections in children through Prevention of Mother-to-Child Transmission.

In 2017, over 7,800 children aged 0 to 14 were newly infected with HIV, a significant drop from over 12,900 in 2013.

This is largely due to Kenya’s scaling up and integration of HIV interventions, including testing and treatment, into maternal neonatal and child health services for pregnant and breastfeeding women and their infants.

Prevention messaging and services aimed at adolescent boys and girls have also contributed in reducing the number of unintended pregnancies and the transmission of HIV.

This is critical because most new HIV infections are among young people and in Kisumu, where the HIV prevalence rate is 16.3 percent, stigma is a major factor preventing young people from getting tested for HIV and accessing life-saving treatment.

A critical challenge still facing the HIV response in Kenya has been the detection of HIV in infants and children.

In 2017, only half of the over 69,400 children born of HIV positive mothers received HIV testing within two months of birth.

The situation is the same in Kisumu County where only half of the children born with the virus are identified within two months of birth.

This is alarming because of the high-risk of death before the age of two years among HIV-infected infants.

HIV infection can progress rapidly among untreated infants – with peak mortality at the age of two-three months.

Ensuring that HIV-infected infants have the earliest possible access to life-saving antiretroviral treatment is a global health priority.

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Given the critical importance of early diagnosis and treatment, WHO recommends that HIV-exposed infants have an HIV test at four to six weeks of age and that results are returned to caregivers as quickly as possible to facilitate immediate initiation of treatment for those infants with a positive test result.

The theme of this year’s World Aids Day is knowing one’s HIV status. Taking an HIV test and obtaining the result, in clinical terms, is relatively simple. For infants under the age of two, however, it is not.

Early infant diagnosis requires advanced machinery handled by skilled personnel in a laboratory.

The testing process and sharing of results can be sluggish as Kenya has only eight national HIV reference laboratories to coordinate and provide early infant diagnosis services to all 47 counties.

Consequently, we miss opportunities in diagnosing close to half of the children born to HIV infected mothers within the recommended time and delay the start in life-saving antiretroviral treatment.

The government and other partners, including UNICEF, launched a new policy for optimising early infant diagnosis and an implementation roadmap for innovative point-of-care diagnostics, which involves performing HIV tests outside a lab at more convenient service delivery points.

In the past 12 months, over 9,000 infants have accessed early infant diagnosis, over 150 were identified as positive of which 99 percent started treatment within the same visit. This testing allows faster clinical decision-making and treatment of infants.

Last week, through her Beyond Zero Campaign, Kenya’s First Lady launched her second Medical Safari, presenting a point of care machine for early childhood HIV diagnosis to Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu.

The machine can detect the virus from birth onwards. Test results are available in one hour as opposed to five to 10 days using previously existing technology.

It is clear that the availability of this technology can make an important difference in HIV prevention and treatment for Kisumu and surrounding counties.

No child in Kenya should be lost to HIV. We can save precious lives through faster, more efficient testing.

Together, we can fight HIV and Aids through early detection and treatment in children. We can win the fight if we join together.

Prof Nyong’o is the Kisumu Governor while Mr Schultink is the UNICEF Kenya Country Office Representative.

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