Ministers and representatives from 12 African countries pledged and outlined their plans to end child AIDS by 2030. International partners set out how they would help countries meet those plans, which were issued at the first ministerial meeting of the Global Alliance to end AIDS in children.
The meeting organized by the United Republic of Tanzania marks a step forward in action to ensure that all children with HIV have access to life-saving treatment and that mothers living with HIV have HIV-free babies. The Alliance will work to drive progress over the next seven years, to ensure the 2030 target is met.
Currently, around the world, a child dies of AIDS-related causes every five minutes.
Only half (52%) of children living with HIV receive life-saving treatment, far behind adults, of whom three quarters (76%) receive antiretrovirals.
In 2021, 160,000 newly acquired children with HIV. Children accounted for 15% of all AIDS-related deaths, despite the fact that only 4% of the total number of people living with HIV are children.
In partnership with networks of people living with HIV and community leaders, the ministers presented their action plans to help find and provide testing to more pregnant women and link them to care. The plans also include finding and caring for babies and children living with HIV.
The Dar-es-Salaam Declaration to end AIDS in children was unanimously approved.
Vice President of the United Republic of Tanzania Philip Mpango said: “Tanzania has shown its political commitment, now we must commit to moving forward as a collective whole. All of us, in our capacities, must have a role to play in ending AIDS in children. The Global Alliance is the right direction, and we must not be satisfied. 2030 is just around the corner.”
The First Lady of Namibia, Monica Geingos, agreed. “This gathering of leaders unites in a solemn vow, and a clear plan of action, to end AIDS in children once and for all,” she said. “There is no higher priority than this.”
Twelve countries with high HIV burdens have joined the alliance in the first phase: Angola, Cameroon, Côte d’Ivoire, Democratic Republic of the Congo (DRC), Kenya, Mozambique, Nigeria, South Africa, United Republic of Tanzania, Uganda, Zambia and Zimbabwe.
The work will focus on four pillars through:
1. Early testing and optimal treatment and care for infants, children, and adolescents;
2. Close the treatment gap for pregnant and lactating women living with HIV, to eliminate vertical transmission;
3. Prevention of new HIV infections among pregnant and lactating adolescents and women; Y
4. Address rights, gender equality, and social and structural barriers that hinder access to services.
UNICEF welcomed the leaders’ commitments and pledged its support. “All children have the right to a healthy and hopeful future, but for more than half of children living with HIV, that future is under threat,” said UNICEF Associate Director Anurita Bains. “We cannot allow children to continue to be left behind in the global response to HIV and AIDS. Governments and partners can count on UNICEF being there every step of the way. This includes working to integrate HIV services into the primary health care and strengthen the capacity of local health systems”.
“This meeting has given me hope,” said Winnie Byanyima, Executive Director of UNAIDS. “One inequity that breaks my heart is the inequality against children living with HIV, and today’s leaders have established their commitment to the determined action that is needed to correct it. As the leaders noted, with the science we have today, no baby need be born with HIV or become infected while breastfeeding, and no child living with HIV should go without treatment. The leaders were clear: they will close the treatment gap for children to save their lives.”
WHO established its commitment to health for all, leaving no child behind in need of HIV treatment. “It’s been more than 40 years since AIDS first emerged, we’ve come a long way in preventing infections among children and increasing access to treatment, but progress has stalled,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director General. “The Global Alliance to End AIDS in Children is a much-needed initiative to reinvigorate progress. WHO is committed to supporting countries with technical leadership and policy implementation to realize our shared vision of ending AIDS in children by 2030.”
Peter Sands, Executive Director of the Global Fund, said: “By 2023, no child should be born with HIV and no child should die from an AIDS-related illness. Let’s take advantage of this opportunity to work in partnership to ensure that the action plans approved today are translated into concrete steps and implemented at scale. Together, led by the communities most affected by HIV, we know we can achieve extraordinary results.”
PEPFAR’s John Nkengasong, US Global AIDS Coordinator, said he remains confident. “Closing the gap for children will require laser focus and a strong commitment to hold ourselves, governments and all partners accountable for results. In partnership with the Global Alliance, PEPFAR is committed to raising the children’s agenda with HIV/AIDS at the highest political level within and in all countries to mobilize the necessary support to address rights, gender equality and social and structural barriers that hinder access to prevention and treatment services for children and your families”.
EGPAF President and CEO Chip Lyons said the shared plans, if implemented, would mean children would no longer be left behind. “Children’s services are often pushed aside when budgets are tight or other challenges get in the way. Today, African leaders endorsed detailed plans to end AIDS in children; now is the time for all of us to commit to championing children to be prioritized and included in the response to HIV.”
Delegates emphasized the importance of a grassroots approach with local, national and regional stakeholders taking the lead and involving a broad set of partners.
“We have helped shape the Global Alliance and have ensured that human rights, community participation and gender equality are pillars of the Alliance,” said Lilian Mworeko, Executive Director of the International Community of Women Living with HIV in East Africa on behalf of ICW, Y+ Global and GNP+. “We believe that a female-led response is key to ending AIDS in children.”
The alliance has gained the support of Africa REACH and various other partners and welcomes all countries to join.
Progress is possible. Sixteen countries and territories have already been certified for the validation of the elimination of vertical transmission of HIV and/or syphilis; Although HIV and other infections can be transmitted from mother to child during pregnancy or while breastfeeding, such transmission can be interrupted with prompt HIV treatment for pregnant women living with HIV or pre-exposure prophylaxis (PrEP) for pregnant women. mothers at risk of HIV infection. .
Last year, Botswana was the first high-HIV prevalence African country to be validated as being on the path to eliminating vertical transmission of HIV, meaning the country had fewer than 500 new HIV infections among babies per 100,000 births. The vertical transmission rate in the country was 2% compared to 10% a decade ago.
UNAIDS, networks of people living with HIV, UNICEF and WHO together with technical partners, PEPFAR and the Global Fund launched the Global Partnership to End Childhood AIDS in July 2022 at the AIDS conference in Montréal, Canada. Now, at their first ministerial meeting, African leaders have set out how the Alliance will deliver on the promise to end AIDS in children by 2030.
