A recent report by the Global Alliance for Ending AIDS in Children by 2030 has revealed that there is an urgent need for an accelerated delivery of HIV services to fulfill the promise of eradicating AIDS in children by 2030.
The report, titled Transforming Vision Into Reality, reveals that programmes targeting vertical transmission of HIV have successfully prevented 4 million infections in children aged 0-14 since 2000. Since 2015, new HIV infections in this age group have decreased by 38 per cent, while AIDS-related deaths have dropped by 43 per cent.
UNAIDS Executive Director Winnie Byanyima praised the progress but emphasized the need for continued efforts. “With the medicines and science available today, we can ensure that all babies are born – and remain – HIV-free, and that all children who are living with HIV get on and stay on treatment. Services for treatment and prevention must be ramped up immediately to ensure that they reach all children everywhere. We cannot rest on our laurels. The death of any child from AIDS-related causes is not only a tragedy but also an outrage.”
Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organisation, stressed the moral and political imperative of accelerating HIV service delivery. “Twelve countries are demonstrating they have made that choice, but significant challenges remain. While we have made progress in increasing access for pregnant women to testing and treatment to prevent vertical transmission of HIV, we are still far from closing the paediatric treatment gap.”
Peter Sands, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, highlighted the need for improved efforts in addressing HIV among children. “In support of national programmes, we have been procuring the latest dolutegravir-based paediatric treatment regimens at negotiated prices. Our investments in laboratory systems are helping ensure exposed infants are rapidly tested and that those that test positive are quickly initiated on age-appropriate antiretroviral treatment.”
The disparity in treatment access between adults and children remains alarming. Only 57 per cent of children living with HIV receive life-saving treatment compared to 77 per cnet of adults. UNICEF Associate Director for HIV/AIDS, Anurita Bains, underscored the urgency of closing this gap, stating,
“Without early and effective testing and treatment, HIV remains a persistent threat to the health and well-being of children and adolescents and puts them at risk of death.”
The situation among young women and girls aged 15-24 is equally concerning, with 210,000 new infections globally in 2023, four times higher than the 2025 target. Gender inequalities and human rights violations exacerbate women’s vulnerability to HIV, limiting their access to essential services.
Ambassador John N. Nkengasong, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy, reaffirmed the commitment to ending AIDS in children. “While much progress has been made, notably through the successful introduction of paediatric dolutegravir, large gaps still remain across the paediatric cascade and we must recommit ourselves with purpose and innovation to fulfill the promises we have made by 2025 and beyond.”
The Global Alliance for Ending AIDS in Children by 2030, launched in 2022 by WHO, UNICEF, and UNAIDS, has grown to include national governments from the most affected countries, civil society movements, and international partners, including PEPFAR and the Global Fund. The twelve member countries are Angola, Cameroon, Côte d’Ivoire, Democratic Republic of the Congo, Kenya, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe.
According to the report, several of the twelve Global Alliance countries have achieved high coverage of lifelong antiretroviral therapy (ART) among pregnant and breastfeeding women living with HIV. Uganda is nearing 100% coverage, with Tanzania at 98%, and South Africa at 97%. Mozambique and Zambia have reached 90% coverage, followed by Angola and Kenya at 89%, Zimbabwe at 88%, and Côte d’Ivoire at 84%.
In 2023, approximately 120,000 children aged 0-14 years old were infected with HIV, with 77,000 of these infections occurring in Global Alliance countries. AIDS-related deaths in this age group numbered 76,000 globally, with 49,000 of these deaths in Global Alliance countries. Vertical transmission rates remain particularly high in some areas, especially in Western and Central Africa, where rates exceed 20% in countries like Nigeria and the Democratic Republic of the Congo.
The Global Alliance countries are employing innovative strategies to overcome barriers and accelerate progress towards ending AIDS in children. However, the world and these countries are currently not on track to meet HIV-related commitments for children and adolescents, and the pace of progress has slowed in recent years.
