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Towards preserving the significant strides in combating HIV and AIDS among children, a new report titled “Transforming Vision Into Reality” by the Global Alliance for Ending AIDS in Children by 2030, has called for a critical increase in HIV services for the most affected countries.
The report which emphasizes the need for further action, highlights the success of programmes targeting mother-to-child transmission (vertical transmission) of HIV. Since 2000, these initiatives have prevented four million infections in children aged 0-14. Globally, new infections in this age group have fallen by 38 percent since 2015, with AIDS-related deaths dropping by 43 percent.
According to the report, despite this progress, significant disparities remain, and many children are still not receiving the critical care they need. The report calls for an urgent scaling-up of HIV services in the countries most burdened by the pandemic to achieve the goal of ending childhood AIDS by 2030.
The report notes that while progress has been made in reducing HIV and AIDS transmission in children, a significant number of new infections and deaths still occur.
In 2023 alone, an estimated 120,000 children under 14 years old contracted HIV globally. Among these, a concerning 77,000 new infections happened within countries targeted by the Global Alliance for Ending AIDS in Children by 2030.
Globally, 76,000 children under 14 died from AIDS in 2023, with a staggering 49,000 of those deaths occurring within the Global Alliance countries. This highlights the need for a more focused and urgent approach in these regions, the report argues.
The high rate of vertical transmission (mother-to-child) in countries such as Nigeria and the Democratic Republic of Congo exceeding 20 percent each way, indicating a critical need for improved prevention and treatment programmes for mothers.
In 2023, there were 210,000 new infections globally among young women and girls aged 15—24 years old (130,000 in Global Alliance countries), four times higher than the 2025 goal set at 50,000. Preventing new infections among this age group is critical both to protect the health and wellbeing of young women and to reduce the risk of new infections among children, the report notes.
UNAIDS Executive Director, Winnie Byanyima said, “I applaud the progress that many countries are making in rolling out HIV services to keep young women healthy and to protect babies and children from HIV.
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“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. Where I come from, all children are our children. The world can and must keep its promise to end AIDS in children by 2030.”
Global Alliance countries are innovating to overcome barriers and accelerate progress towards ending AIDS in children. However, despite advances neither the world nor Global Alliance countries are currently on track to reach HIV-related commitments for children and adolescents and the pace of progress in preventing new HIV infections and AIDS-related deaths among children has slowed in recent years.
Director-General of the World Health Organization, Dr Tedros Adhanom Ghebreyesus said,“Accelerating the delivery and uptake of HIV services for children and adolescents is a moral obligation, and a political choice. 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 pediatric treatment gap.
“We need to further strengthen the collaboration and reach of the Global Alliance, and we must do this work with focus, purpose and in solidarity with all affected mothers, children, and adolescents.”
Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, GFTAM, Peter Sands noted,“In the fight against HIV, we must do a much better job for children. We have procured the latest dolutegravir-based paediatric treatment regimens to support national programs 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. Differentiated testing and treatment approaches are helping close the diagnostic gap and ensuring more child-centered service delivery.”
UNICEF Associate Director HIV and AIDS, Anurita Bains adds, “Just 57 per cent of children living with HIV receive life-saving treatment, compared to 77 per cent of adults. 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.
“To close the treatment gap, we must support governments to scale up innovative testing approaches and ensure children and adolescents living with HIV receive the treatment and support they need.”
United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy, Dr John N. Nkengasong said, “It has been remarkable to see how many more children’s lives can be saved when all stakeholders and partners come together to commit to end 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 was launched in 2022 by WHO, UNICEF and UNAIDS to reinvigorate the paediatric HIV agenda. In addition to the UN agencies, the Alliance includes civil society movements, including the Global Network of People living with HIV, national governments in the most affected countries, and international partners, including PEPFAR and the Global Fund.
Nigeria, Angola, Cameroon, Côte d’Ivoire, Democratic Republic of the Congo (DRC), Kenya, Mozambique, South Africa, United Republic of Tanzania, Uganda, Zambia, and Zimbabwe are members.
Among the Global Alliance countries, several have achieved strong coverage of lifelong antiretroviral therapy among pregnant and breastfeeding women living with HIV, with Uganda nearing 100 percent.
Others include United Republic of Tanzania at 98 percent; South Africa at 97 percent; Mozambique 90 percent; Zambia 90 percent; Angola 89 percent; Kenya 89 percent; Zimbabwe 88 percent, and Cote d’Ivoire at 84 percent coverage.