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AIDS Epidemic Grows Among Children

MICHEL MARTIN, host:

I'm Michel Martin, and this is Tell Me More from NPR News. Coming up, our weekly spotlight on the Washington Post Magazine focuses on the story of a young woman who undergoes a painful procedure in order to become taller. We'll talk to her about that in just a few minutes.

But first, today is World AIDS Day. We're going to be turning our attention to the global epidemic throughout the week. Today, though, we want to focus on children. It's estimated there are two million children under the age of 15 living with HIV. Almost 90 percent are in Sub-Saharan Africa, according to the UN's 2008 AIDS report. Joining us now to talk about this is Pamela Barnes. She's the president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation. She's here with me in the studio. Welcome. Thanks so much for stopping by.

Ms. PAMELA BARNES (President and CEO, Elizabeth Glaser Pediatric AIDS Foundation): Thank you, Michel.

MARTIN: Pam, you and your organization have been working on HIV issues for many, many years globally. The number of children living with HIV has actually increased from 2001 to 2007, the latest figures available from about 1.6 million to about two million. How do we interpret this? Does this mean we're making progress because more kids are surviving? Does this mean we're not making progress because more kids are infected?

Ms. BARNES: Well, we are making progress because kids are surviving, and when you see the wonderful children living healthy lives in Sub-Saharan Africa and around the world, you know we are making progress. But so much more needs to be done. You know, for every one person that's put on treatment, there are three, four new infections, so we're not ahead of that curve. But what is interesting about children is that infections in children are totally preventable, and that's really where we know we can make a huge difference.

MARTIN: Why is it that 90 percent of the kids living with HIV are in Sub-Saharan Africa?

Ms. BARNES: Well, I think that, you know, again, in the United States and the developed world back 10, 15 years ago, when the disease really foreshowed itself, let's say, 10 years ago, we really were able to respond quickly with education programs and with the treatment that was really necessary for HIV-positive mothers so that in the United States, for example, fewer than two percent of HIV-positive moms have an HIV-positive baby. That's fewer than 200 children a year born HIV positive. But we don't have the infrastructure in Sub-Saharan Africa. We don't necessarily have the access to medical care in Sub-Saharan Africa. But what we do have, Michel, are the tools.

MARTIN: Tell me what are the tools to achieving those low rates of transmission. What is the critical piece?

Ms. BARNES: In the very simplest form, what we need to do is know the mom's status. So, ideally, a mom comes in for at least one prenatal care visit, and in most parts of even the developing world, the poorest parts of the world, most mothers come in for at least one pre-natal visit. And if we can capture there the HIV test and know the mom's status in its very simplest form, Michel, we can deliver one drug to a mom during labor and significantly reduce her chances of having an HIV-positive baby.

If, in fact, we have access to mom or mom comes in more often, we can give her a series of drugs which reduce the likelihood of transmission to the baby even further down toward that two percent level. So we have an opportunity with moms at the very simplest level. In labor, if that's when mom comes in and we know her status, we can give her a drug. We also have an opportunity, given the fact that mom comes in and we know her status, then to try to know what the status of the baby is.

And there was a stock-taking(ph) report that came out from UNICEF today, and in fact, what they indicated is we really need to get earlier diagnoses for those babies. If a baby is born HIV positive, we must really know that baby's status as quickly as possible. We will lose half of those children before they're two years old.

MARTIN: President Bush, I think most people agree, had a pretty significant commitment to combating HIV/AIDS in Africa. What are your hopes for President-elect Obama? What are the specific things that you would like to see him either build on or do differently as we go forward?

Ms. BARNES: Well, this program of outreach by the people of the United States to help people around the world who are suffering from HIV is a successful program, and that's the message that the American people need to hear. If I tell you the number of times that a mom has come to me, personally, in any number of countries where the foundation works, and that mom says to me, please thank the American people for what you've done to help us, truly there is a lot of gratitude.

What I would love to hear President Obama say is not only the continued commitment to this program, but helping us make it truly sustainable. Remember, once a person is on treatment, they need that treatment for life.

MARTIN: But tell me, how is this program successful since we still have more kids getting infected?

MS. BARNES: Because even five years ago, before this program started, we had fewer than 20,000, 25,000 people on treatment. The numbers are now in the millions. We are making progress. And with respect to prevention, mother-to-child transmission, only two years ago numbers said we were reaching fewer than 15 percent of the moms. In two years' time that number has doubled, so we are making progress. Remember, it's five years, and we're already seeing that progress.

MARTIN: Do you think that in our lifetime, yours and mine, that we will see transmission rates around the world as low as they are in the U.S. and in the rest of the West?

Ms. BARNES: I think we are going to see significant progress. I do think that we can drive very close to what we see in the West. Remember the other challenges. We've got to integrate with health care across the board. Children die of diarrhea and pneumonia in these countries, too. So it's not that we can't just look at it as fighting AIDS. We've got to look at AIDS integrated in health care. We firmly believe that we can do that again by working with the local governments, by working with people in their countries. This is not our health care system. It belongs to the people in the countries.

MARTIN: Pamela Barnes is the president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation. She was kind enough to join us here in our studio in Washington. Thank you so much for starting off our discussion about World AIDS Day.

Ms. BARNES: Thank you, Michel. Thanks for having me.

MARTIN: Remember, with Tell Me More, the conversation never ends. We'd like to know how your community is observing World AIDS Day. Are they promoting abstinence, promoting condom use, helping people learn their HIV status? And are you living with HIV? Do you want to send a message to our listeners about how you are coping? To tell us more and to compare notes with other listeners, please go to our blog at npr.org/tellmemore. You can also call our comment line at 202-842-3522. Again, that's 202-842-3522. Transcript provided by NPR, Copyright NPR.

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