At the first ministerial meeting of the Global Alliance to end AIDS in children, leaders from 12 African countries discussed their commitments to ending AIDS in children by 2030. The meeting took place in the United Republic of Tanzania, in Dar es Salaam. A WHO statement described the meeting as a “step up in action” to ensure that “all children with HIV have access to life saving treatment” and “mother living with HIV have babies free from HIV”. With 7 years until 2030, the Alliance is hoping to accelerate progress to meet the target.  

UNAIDS, together with UNICEF, WHO, networks of people living with HIV, PEPFAR, and The Global Fund devised the Global Alliance to end AIDS in children in July at the AIDS conference in Canada. 12 countries with high HIV burdens participated in the first phase: Angola, Cameroon, Côte d’Ivoire, the Democratic Republic of the Congo, Kenya, Mozambique, Nigeria, South Africa, the United Republic of Tanzania, Uganda, Zambia, and Zimbabwe. 

The burden of AIDS in children 

WHO states that a child dies from “AIDS related causes” every 5 minutes. Furthermore, children accounted for 15% of all AIDS-related deaths in 2021, despite only 4% of people with HIV being children. Furthermore, only 52% of children living with HIV are receiving life-saving treatment. This falls behind adult care, with 76% of adults with HIV receiving antiretrovirals.  

“In 2021, 160,000 children newly acquired HIV.”  

Sadly, during the COVID-19 pandemic progress against HIV slowed, as noted in the UNAIDS report of 2022. Yet WHO believes “progress is possible”. Transmission of HIV and other infections through pregnancy or breastfeeding can be “interrupted” through prompt HIV treatment or pre-exposure prophylaxis (PrEP).  

Plans in place 

Ministers in attendance sought advice from networks of people living with HIV and community leaders to develop action plans to identify and test pregnant people, linking them to care, as well as to find and care for infants and children with HIV. The Dar es Salaam Declaration, which can be read here, was endorsed unanimously.  

Philip Mpango is the Vice-President of the United Republic of Tanzania. He was pleased with Tanzania’s “political engagement” and hope to move forward as a “collective whole”.  

“All of us in our capacities must have a role to play to end AIDS in children…we must not remain complacent. 2030 is at our doorstep”.  

The work centres on 4 pillars: 

  1. Early testing and optimal treatment and care for infants, children, and adolescents. 
  2. Closing the treatment gap for pregnant and breastfeeding women living with HIV, to eliminate vertical transmission. 
  3. Preventing new HIV infections among pregnant and breastfeeding adolescent girls and women. 
  4. Addressing rights, gender equality, and the social and structural barriers that hinder access to services. 
High priorities and hope 

Namibia’s First Lady, Monica Geingos, described the gathering of leaders to end AIDS in children as a “solemn vow”.  

“There is no higher priority than this.” 

UNICEF Associate Director Anurita Bains agreed that “every child has the right to a healthy and hopeful future”, assuring global leaders that they can “count on UNICEF to be there every step of the way”. Winnie Byanyima, Executive Director of UNAIDS, found “hope” in the meeting

“An inequality that breaks my heart is that against children living with HIV, and leaders today have set out their commitment to the determined action needed to put it right.” 

WHO Director-General Dr Tedros Adhanom Ghebreyesus recognised that we have “come a long way in preventing infections” and “increasing access to treatment”. However, “progress has stalled”.  

“WHO is committed to supporting countries with the technical leadership and policy implementation to realise our shared vision of ending AIDS in children by 2030.”  

A laser focus meets community leadership 

The Global Fund’s Executive Director Peter Sands said that “in 2023, no child should be born with HIV, and no child should die from an AIDS-related illness”.  

“Let’s seize this opportunity to work in partnership to make sure the action plans endorsed today are translated into concrete steps and implemented at scale. Together, led by communities most affected by HIV, we know we can achieve remarkable results.”  

John Nkengasong of PEPFAR is confident in the power of partnership. 

“Closing the gap for children will require laser focus and a steadfast commitment to hold ourselves, governments, and all partners accountable for results.”  

PEPFAR is committed to elevating the HIV/AIDS agenda to the “highest political level” and mobilising the “necessary support”. EGPAF President and CEO Chip Lyons hopes that this will be a turning point to overcoming the “challenges” that “stand in the way” of children’s services, such as “tight” budgets.  

Lilian Mworeko, Executive Director of the International Community of Women living with HIV in Eastern Africa is working to ensure that “human rights, community engagement, and gender equality are pillars of the Alliance”. 

“We believe a woman-led response is key to ending AIDS in children.”  

What other approaches might be essential in meeting the 2030 target? What advice would you give to world leaders who are responsible for partnerships to this end? 

After the disappointing news of an unsuccessful vaccine trial for HIV, we are eager to hear more on vaccine updates. Join us at the World Vaccine Congress in Washington for more on this front.