Statement by His Excellency Archbishop Silvano M. Tomasi
Permanent Observer of the Holy See to the United Nations and Other International
Organizations in Geneva
“Annual full-day meeting on the rights of the child”
Geneva, 7 March 2013
Mr.
President,
My Delegation
welcomes the focus on the Child’s Right to Health during this Annual
Discussion. Allow me to call special attention to the situation of children
living with HIV or with HIV/TB co-infection – a topic that could have received
more extensive consideration in the Report of the High Commissioner in
preparation for this important discussion.
Despite evidence that treatment
is very successful in children living with HIV, even in resource-limited
settings, there remain significant obstacles to expanding access for children
living with HIV to such life-saving and life-enhancing treatment. In fact, only
28% of children living in low- and middle-income countries in need of highly
active anti-retroviral treatment, or HAART, are currently able to benefit from
such medications, compared with 50% of adults living with HIV who have access
to ART.[1] As a
result, 30 children under 15 years of age living with HIV die every hour.[2] For
children living with both HIV and tuberculosis (TB), the situation is even
worse; despite the fact that TB remains the main cause of death among children
with AIDS, pediatric drug formulations are not available to treat HIV/TB
co-infection in children.
One major barrier to treating
children with HIV is the difficulty of detecting the infection in babies
younger than 18 months. In high-income countries, children can be diagnosed
accurately within 48 hours of birth. However, the specialized and sophisticated
tests that permit such diagnosis among infants are not commonly available in
low-income countries because they require expensive laboratory equipment and
trained staff. Moreover, scale-up of testing programs for children requires
investment in training and technical assistance for health care providers,
improvement of laboratory capacity and facilities, and referral networks and
community mobilization.
We know, of course, that 90% of
HIV infection among children is transmitted from a mother who is living with
the virus to her child while still in the womb, during the birth process, or
during breastfeeding. Even though interventions are available to prevent the
transmission of HIV from mother to child, approximately 330,000 children were
newly infected with HIV during 2011[3], mainly
through mother-to-child transmission. If
access to special programs to prevent mother-to-child transmission through
early diagnosis of the mothers and through provision of anti-retroviral
treatment to such mothers immediately upon diagnosis were increased, the number
of children newly infected with HIV would soon decrease. Moreover, the
immediate initiation of HAART among children born to HIV-positive mothers would
delay the onset of HIV-related illnesses among such children.
Without adequate care and
treatment, up to one third of all children born with HIV die before their first
birthday, and half of them will die before they are two years old. Yet children
treated with HAART, must take three or more different anti-retroviral drugs
several times a day in order to avoid developing resistance to a single drug,
and therefore to prevent the further progression of HIV disease. These
medicines must be formulated differently than those for adults, and in a way
that takes into consideration the climatic conditions in the areas in which
they will be distributed and used. It also should be noted that, in many
low-income settings, clean drinking water, adequate nutrition, and a continuous
supply of electricity are not always available and can therefore further jeopardize
the quality of treatment that a child can access. Indeed, an insufficient
variety of formulations of antiretroviral medicines are available for specific
use among children, “largely because the HIV medicine market for children
was judged too small to warrant investments in such research”[4].
Mr. President, the
above-mentioned barriers thwart the ability of the child to enjoy and exercise
his or her right to the highest attainable standard of physical and mental
health, recognized, inter alia, in
the Convention on the Rights to the Child. My delegation speaks her not merely
in an abstract or legalistic manner but on the basis of information and lived
experience reported by Catholic Church-related organizations engaged in
promoting and protecting the child’s right to health in every part of the
world. A recent study conducted by the Catholic HIV/AIDS Network, an informal
network of Catholic Church-related organizations engaged in providing financial
and technical assistance support to HIV programs in developing countries
reports significant engagement by such programs in efforts to eliminate
mother-to-child transmission of the virus, to promote comprehensive and early
diagnosis and treatment of those children who have been infected, and to
confront the social stigma and ignorance that often obstructs the effective and
efficient implementation of such programs. This report was discussed in a
parallel event, held on 6 March 2013, in conjunction with the 22nd
Session of this Council.
In an appeal on
World AIDS Day 2012, Pope Benedict XVI noted with much urgency: “HIV/AIDS particularly affects
the poorest regions of the world, where there is very limited access to
effective medicines. My thoughts turn in particular to the large number of
children who contract the virus from their mothers each year, despite the
treatments which exist to prevent its transmission. I encourage the many
initiatives that, within the scope of the ecclesial mission, have been taken in
order to eradicate this scourge.”[5]
Mr. President, my Delegation sincerely hopes that
this Council itself will appeal to the Member States of the United Nations to
invest funds and collaborate closely with pharmaceutical companies and research
institutes in order to preserve and advance the life and dignity of children
living with HIV or with HIV/TB co-infection by providing them with available,
affordable, and accessible diagnostic tools and medications and thereby
assuring their full enjoyment of the right to health.
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