Press Release: Clinton Foundation, UNITAID, France, and WHO Support Governments to Turn Policy into Practice to Save More Infants Living with HIV

WHO adopts policy to treat all HIV-positive children under 12 months of age as the Clinton Foundation partners with UNITAID and national governments to enact new policy quickly and provide required commodities and on-the-ground support.

President Bill Clinton today joined French Minister of Cooperation Mr. Alain Joyandet, Chairman of UNITAID Philippe Douste-Blazy, and WHO Representative in Senegal Dr. Antonio Pedro Filipe to announce a new policy adopted by WHO encouraging countries to treat all HIV-positive children under 12 months of age, a policy that could lower mortality and morbidity rates among infants four-fold. UNITAID and the Clinton HIV/AIDS Initiative (CHAI) will facilitate the implementation of the new policy through their partnership to support 33 countries' provision of commodities and care for HIV-positive children.

“Thousands of children infected with HIV go without treatments that could save their lives,” said President Bill Clinton. “This revolutionary new policy is a necessary step to ensure that infants are diagnosed at an early stage, treated with proper medicines, and given follow-up care to help them grow and thrive.”

Today's announcement was made in Senegal, which already has adopted the new policy and is receiving support from CHAI and UNITAID. Senegal and other developing countries previously adhered to WHO guidelines for resource-limited countries. Under the previous guidelines, treatment initiation depends on specific biological and clinical indicators, including CD4 count and progression symptoms. Due to the rapid progression of HIV in infants, such thresholds are poor indicators of immune system function. In South Africa, an ongoing study has revealed preliminary data that morbidity and mortality were four times higher among infants who received treatment, based on the old thresholds when compared with infants who received ART immediately upon diagnosis. The results of this study rely on the use of a different drug regimen than used previously to initiate treatment. The new regimen is more than three times as expensive as the previous one.

According to Mr. Alain Joyandet, French Minister of State for Cooperation and Francophony, “This is a remarkable announcement and step forward for Senegal, which is the first beneficiary of French development aid. France is and will remain at the forefront of the fight against HIV/AIDS. We strongly appreciate and support UNITAID and its fruitful partnership with Clinton Foundation.”

UNITAID was created in 2006 by France with four other countries (Brazil, Chile, Norway, and United Kingdom) as a new funding mechanism to fight AIDS, tuberculosis, and malaria – financed with sustainable, predictable, and additional funding. France is the major contributor to UNITAID, providing up to 70 percent of resources, thanks to a levy on airline tickets. UNITAID has approved $480 million in funding for 16 programs, with nine implementing partners including CHAI. UNITAID's financial support enables countries to rapidly and flexibly adopt guidelines despite financial and logistical limitations, such as the higher cost of one formulation often used in infant treatment.

“We have made enormous strides already and we are continuing to scale up,” said Dr Philippe Douste-Blazy, chair of UNITAID's Executive Board. “I would like to call on other global players to join our efforts and make universal access a reality in the shortest time possible.”

“This is very welcome news,” said Kevin Decock, Director, Department of HIV/AIDS, WHO. “It's an important step towards protecting the health of the children of Senegal.”

Without care or treatment, half of children born with HIV die by the age of two, and four out of five die by age five. The WHO estimates that 800,000 HIV-positive children are in need of treatment. At the end of 2007, 200,000 had access to treatment, a ten-fold increase in three years. Still, the ratio of access for children, currently 25 percent, remains significantly less than that of adults, 31 percent.

Treatment of infants in the developing world has been challenging due to the added capacity needed for testing, initiation, and treatment of infants. Diagnosing children less than 18 months requires high-cost, centralized testing often made accessible through sample transport systems. A combination of spotty early- infant diagnosis coverage, weak referral of infants into care, poor understanding of pediatric HIV infection, unavailability of infant-friendly ARV formulation, and national and international guidelines all have kept infants from receiving lifesaving ART on a large scale. In the past year, under the strong leadership of national governments, early infant diagnosis has moved from pilot, research-only coverage to significant national public availability, doubling early-infant diagnosis sites across 12 high-volume countries from approximately 150 to over 1200;infant-friendly formulations such as pediatric dispersible fixed dose combinations are available in 29 countries; CHAI, in collaboration with UNITAID, has funded over $50 million dollars of pediatric commodities; the number of ART sites treating children jumped by 70 percent; and pediatric treatment has scaled up from 21,000 to over 135,000 children across all 33 countries in which CHAI's pediatrics program operates This announcement comes at the end of President Clinton's annual trip to Africa, following visits to Clinton Foundation projects in Ethiopia, Rwanda, and Liberia. Today, President Clinton travels from Dakar, Senegal, to Mexico City, where he will address the 2008 International AIDS Conference. President Clinton will discuss the global advances that have been made since 2006 in the fight against HIV/AIDS, key contributions made by the Clinton Foundation, and the steps required in order to achieve universal access and treatment.

For more information, please visit www.clintonfoundation.org/africa.

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