Urgent Action Needed to End AIDS in Children by 2030, Reports Global Alliance

Among the twelve Global Alliance countries, several have made significant progress in providing lifelong antiretroviral therapy to pregnant and breastfeeding women living with HIV.

Despite significant strides in reducing HIV infections and AIDS-related deaths among children, a new report released by the Global Alliance for Ending AIDS in Children by 2030 highlights the urgent need for scaling up HIV services in the hardest-hit countries to achieve the goal of ending AIDS by 2030.

The report, titled Transforming Vision Into Reality, showcases that programs targeting the vertical transmission of HIV have averted 4 million infections among children aged 0-14 since 2000. Globally, new HIV infections among children in this age group have declined by 38% since 2015, and AIDS-related deaths have fallen by 43%.

Among the twelve Global Alliance countries, several have made significant progress in providing lifelong antiretroviral therapy to pregnant and breastfeeding women living with HIV. Uganda is nearing 100% coverage, followed by the United Republic of Tanzania at 98%, and South Africa at 97%. Other notable mentions include Mozambique and Zambia at 90%, Angola and Kenya at 89%, Zimbabwe at 88%, and Côte d'Ivoire at 84%.

"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," said UNAIDS Executive Director, Winnie Byanyima. "With the medicines and science available today, we can ensure that all babies are born – and remain – HIV-free, and that all children living with HIV get on and stay on treatment. Services for treatment and prevention must be ramped up immediately to ensure they reach all children everywhere. The death of any child from AIDS-related causes is a tragedy and an outrage."

The report stresses that while there have been advances, neither the global community nor the Global Alliance countries are on track to meet HIV-related commitments for children and adolescents. The pace of progress in preventing new HIV infections and AIDS-related deaths among children has slowed in recent years.

"Accelerating the delivery and uptake of HIV services for children and adolescents is a moral obligation and a political choice," said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. "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 strengthen collaboration and reach of the Global Alliance with focus and purpose."

In 2023, around 120,000 children aged 0-14 became infected with HIV, with approximately 77,000 of these infections occurring in Global Alliance countries. AIDS-related deaths among children aged 0-14 numbered 76,000 globally, with Global Alliance countries accounting for 49,000 of these deaths. Vertical transmission rates remain high in some locations, particularly in Western and Central Africa, where rates exceed 20% in countries like Nigeria and the Democratic Republic of the Congo.

"In the fight against HIV, we must do a much better job for children," said Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria. "We have been procuring the latest dolutegravir-based pediatric treatment regimens at negotiated prices. Our investments in laboratory systems ensure exposed infants are rapidly tested and those testing positive are quickly initiated on age-appropriate antiretroviral treatment."

The treatment gap between adults and children remains a significant concern. "Just 57% of children living with HIV receive life-saving treatment, compared to 77% of adults," said UNICEF Associate Director of HIV/AIDS, Anurita Bains. "To close this gap, we must support governments to scale up innovative testing approaches and ensure children and adolescents living with HIV receive the necessary treatment and support."

In 2023, there were 210,000 new infections globally among young women and girls aged 15-24, with 130,000 of these occurring in Global Alliance countries. Preventing new infections in this age group is critical to protecting young women's health and reducing the risk of new infections among children.

Gender inequalities and human rights violations increase women's vulnerability to HIV and limit their access to essential services. Nearly one in three women globally has experienced violence in their lifetime, with adolescent girls and young women disproportionately affected by intimate partner violence. In the four Global Alliance countries with available data, countries are not on track to achieve the target of reducing gender-based inequalities and violence by 2025.

"It has been remarkable to see how many more children's lives can be saved when all stakeholders commit to ending AIDS in children," said Ambassador John N. Nkengasong, U.S. Global AIDS Coordinator. "While much progress has been made, large gaps remain, and we must recommit with purpose and innovation to fulfill our promises 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 pediatric HIV agenda. It includes civil society movements, national governments in the most affected countries, and international partners like 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, United Republic of Tanzania, Uganda, Zambia, and Zimbabwe.

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