Children

An advocacy toolkit to support a campaign by the first ladies of Africa to end childhood HIV and keep mothers healthy has been launched. The toolkit was developed as part of the Free to Shine campaign, an initiative of the Organization of African First Ladies for Development (OAFLAD) and partners to address the growing complacency in the response to childhood HIV in Africa.

Important gains have been made in the AIDS response for women and children. An estimated 1.5 million new HIV infections among children aged 0–14 years have been averted since 2010 in Africa. The proportion of pregnant women living with HIV on antiretroviral therapy increased from 44% in 2010 to 84% in 2018. However, challenges remain across the continent. AIDS remains the leading cause of death among women of reproductive age. Only half of all children living with HIV have access to antiretroviral therapy, leaving 742 000 children who are neither tested not treated for HIV. Coverage of services to prevent vertical (mother-to-child) transmission of HIV has stalled in eastern and southern Africa and decreased in western and central Africa in the past three years.

The toolkit sets out three areas that the first ladies should focus their advocacy efforts on: keeping women and girls HIV-free; preventing vertical transmission of HIV; and finding missing children and adolescents living with HIV and ensuring that they receive HIV services. Showing how to take the advocacy focus areas forward, the toolkit sets out the background to the three focus areas and gives key messages. A framework for action outlines how the first ladies should use their unique position to raise awareness, convene stakeholders, take action and promote community leadership.

Speaking at the launch, Winnie Byanyima, Executive Director of UNAIDS, said, “We must focus on what is needed next to achieve progress, accelerate our efforts to keep women and girls HIV-free, prevent HIV transmission from a mother to her baby and find the missing children and adolescents living with HIV.”

“We have made critical strides in the fight to end AIDS, but there’s still so much more to be done. We are seeing mother-to-child transmission rates rising in several countries, and we have to prioritize these vulnerable populations. Only with stronger, targeted programmes and campaigns like Free to Shine can we put women and children’s needs at the centre and achieve a generation free of AIDS,” said Chip Lyons, President and Chief Executive Officer of the Elizabeth Glaser Pediatric AIDS Foundation.

OAFLAD, the Elizabeth Glaser Pediatric AIDS Foundation and UNAIDS launched the toolkit on 9 February in Addis Ababa, Ethiopia, during the general assembly meeting of OAFLAD.

How innovations in rapid testing and child-friendly medicines are saving lives in Uganda.

By Karin Schermbrucker and Adrian Brune — Originally published by UNICEF

Last year, nearly 450 infants acquired HIV every day – most of them during childbirth. These children are at extremely high risk of dying in the first two years of life. But so many of them are never diagnosed or treated.

Inadequate HIV testing and treatment for children is a widespread challenge. Although the 2019 global treatment rate for HIV-positive mothers stands at 82 per cent, the diagnosis and treatment of children with HIV is just 54 per cent in most regions.

This gap in coverage is often because diagnostic processes tend to be more complicated and cumbersome for children. Infants require a special type of testing for HIV (virological), which is not readily available in most low- and middle-income countries.

And although there are age-appropriate antiretroviral medicines for children, they can be hard to find in many areas largely due to a lack of investment in testing them. 

This delayed diagnosis and treatment doesn’t have to happen. UNICEF and Uganda’s Ministry of Health recently enacted HIV treatment reforms for children to great success. With the help of partners and innovative diagnostic tools, 553 facilities across the country were able to provide antiretroviral therapy for children – up from 501 in 2017.

Dr. Denis Nansera, a paediatrician, examines Kansiime Ruth, 25, and her daughters aged 1 and 4 years, at the Mbarara Regional Referral Hospital in Mbarara District, Western Region, Uganda on 20 August 2019. "A good number of mothers used to fall out of antenatal care. But with (medical advancements), we see a huge reduction in the time taken to diagnose a child, and time taken to get child on medication,” Dr. Nansera says. Photo: UNICEF/UNI211885/Schermbrucker

Kansiime's one-year-old daughter is weighed and measured at the Mbarara Regional Referral Hospital on 20 August 2019. UNICEF, in partnership with the Ministry of Health of Uganda and the Clinton Health Access Initiative has implemented Point of Care Early Infant Diagnostic (POC EID) testing. This rapid testing process uses devices that are easy to transport, operate and maintain, allowing more health centres to diagnose infants. With early diagnosis, infants can immediately start anti-retroviral therapy. Photo: UNICEF/UNI211886/Schermbrucker

Enoch Turyatemba, a laboratory technician at Mbarara Regional Referral Hospital, takes a blood sample from a baby for early infant diagnosis testing, which screens for HIV and determines results on the same day. "Before the Point of Care [POC] machines, we collected dry blood samples and had to send them away. The turn-around time was sometimes months,” Enoch says. “With a POC machine, HIV-positive children can start treatment the next day. “We are saving lives,” Enoch adds. Photo: UNICEF/UNI211916/Schermbrucker

Enoch Turyatemba tests a sample of blood with the POC machine. In addition to the rapid testing, the Ministry of Health has approved the use of oral pellets of pediatric HIV medicine, which can be mixed with food and/or breast milk to disguise the bitter taste of the medication. The pellets also do not require refrigeration – a huge advancement. Photo: UNICEF/UNI211884/Schermbrucker

Kenyonyozi Joseline holds her baby inside the POC clinic at the Mbarara Hospital. Adolescent girls are more vulnerable to HIV infection because their reproductive systems are not fully developed. Gender inequality and patriarchal norms in Uganda also make it difficult for girls and young women to negotiate safe sex, predisposing them to early pregnancies and HIV. Photo: UNICEF/UNI211905/Schermbrucker

Kenyonyozi carries her baby on her back outside the the POC clinic. Paediatric HIV services lag considerably behind those for adults and pregnant women. While 82 per cent of mothers living with HIV receive treatment, only 54 per cent of children living with HIV are accessing life-saving drugs. Just 59 per cent of babies born to mothers living with HIV are tested for HIV within the first two months of life. Photo: UNICEF/UNI211891/Schermbrucker

Kansiime and her daughters arrive at the Mbarara Hospital. The three family members all live with HIV and go to the clinic regularly to collect their medication. "When I go to hospital, I am surrounded by other women who have come for treatment. We are there for the same reason,” Kansiime says. “This has helped me overcome stigma and given me strength." Photo: UNICEF/UNI211907/Schermbrucker

Kansiime gives her one-year-old daughter her paediatric HIV medicine at home in western Uganda. Her daughter now takes the oral pellets instead of the bitter syrup she used to use, which has helped her viral load. "It is much easier to give her the pellets mixed into food so she doesn’t struggle with the taste,” Kansiime says. “My advice to other mothers: Give your children the medication they need so they can live longer and educate others." Photo: UNICEF/UNI211882/Schermbrucker

Kansiime's four-year-old daughter peeks her head outside the door to her house. She was born with HIV and needs to take medication on a daily basis. But she has survived past the critical period for young children and infants, making her survival into adolescence and beyond more likely. “I love singing – my favorite song is a song called Sconto,” she says. Photo: UNICEF/UNI211903/Schermbrucker

Kabiite Ajara, 32, helps her baby take her paediatric HIV medication in their home in Isongo, Uganda. They are both living with HIV. "I give my baby medication once a day,” she says. “Initially medicine used to make her weak and vomit. But currently she is ok with the drug – I crush the tablet and put it into water, which she takes easily." Photo: UNICEF/UNI211928/Schermbrucker

Kabiite plays with her daughter outside their home. Kabiite is HIV-positive, but regular medication keeps her strength – and spirits – high. "I love playing with my children – taking them to play in the banana plantation, cooking together,” Kabiite says. “[My daughter] loves playing football a lot! And she is good!” Photo: UNICEF/UNI211933/Schermbrucker

This World AIDS Day, UNICEF is calling on all governments and partners to urgently close the testing and treatment gap for children and adolescents living with HIV-AIDS; to establish supportive, stigma-free communities that provide opportunities for testing and care; and to enact improved policies and rights for people living with this survivable epidemic.

As global 2018 targets are unmet, Start Free, Stay Free, AIDS Free report shows that efforts need to focus on the countries falling behind

GENEVA/MEXICO CITY, 22 July 2019—A new report released today at the 10th  IAS Conference on HIV Science in Mexico City, Mexico, shows that the world is lagging behind in its commitment to end the AIDS epidemic among children and adolescents. The report, Start Free, Stay Free, AIDS Free, shows that the pace of progress in reducing new HIV infections among children and expanding access to treatment for children, adolescents and pregnant women living with HIV has slowed significantly and that global targets set for 2018 have been missed, despite important gains being made in some countries.  

Globally, around 160 000 children aged 0–14 years became newly infected with HIV in 2018. This is a major decrease from 240 000 new infections in 2010. However, the bold and important target set for 2018 was fewer than 40 000 new infections.

“The failure to reach the 2018 targets to reduce new HIV infections among children and adolescents and to widen access to life-saving treatment is both disappointing and frustrating,” said Gunilla Carlsson, UNAIDS Executive Director, a.i.  “We need to act quickly to turn this situation around and honour the commitment to end the AIDS epidemic for the next generation.”

Around 82% of pregnant women living with HIV now have access to antiretroviral medicines. There has been considerable progress among countries in eastern and southern Africa, with more than 90% of pregnant women accessing antiretroviral medicines in Ethiopia, Kenya, Uganda, United Republic of Tanzania and Zimbabwe and 95% or higher in Botswana, Malawi, Mozambique, Namibia and Zambia. This has resulted in a 41% reduction in new HIV infections among children, with remarkable reductions achieved in Botswana (85%), Rwanda (83%), Malawi (76%), Namibia (71%), Zimbabwe (69%) and Uganda (65%) since 2010. The progress made by these countries shows what can be achieved through strong political leadership, rapid policy adoption and concerted efforts by all stakeholders.

The report throws light on where gaps need to be filled to prevent new HIV infections occurring among children. For example, in eastern Africa, 10 000 of 26 000 new HIV infections among children in 2018 were the result of women not being retained on treatment throughout pregnancy and breastfeeding. In southern Africa, 17 000 of 53 000 new infections among children were the result of the mother becoming infected with HIV during pregnancy or breastfeeding. A total of 16 000 new infections could have been averted in southern Africa by retaining mothers on treatment throughout pregnancy and breastfeeding. In western and central Africa, almost 27 000 of the 44 000 new infections could have been averted if their mothers had accessed antiretroviral medicines.

“These new data show that many countries have made important progress toward reaching the 2020 targets, and yet others are lagging significantly behind,” said Deborah Birx, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy. “These stark disparities highlight the critical role of political commitment, rapid policy implementation and data-driven investments in accelerating impact.”

Country-level analysis of how mother-to-child transmission of HIV happens can provide vital information to shape national responses.

“Ending AIDS and achieving universal health coverage means leaving no one behind. Yet, too many children and adolescents with HIV are still missing out on the chance to grow up in full health as they can’t access treatment,” said Ren Minghui, the World Health Organization’s Assistant Director-General for Universal Health Coverage/Communicable and Noncommunicable Diseases. “We need to intensify our efforts to and keep our promise to these children.” 

Children living with HIV are also being left behind in HIV treatment scale-up and are not being diagnosed and treated early enough. An estimated 940 000 children aged 0–14 years were accessing treatment in 2018, double the number that were on treatment in 2010 but far short of the target of 1.6 million set for 2018.

Children living with HIV are still less likely to have access to HIV treatment than adults living with HIV, a disparity that is widening in some countries, especially in western and central Africa. As a result, the AIDS epidemic is still claiming the lives of many children aged 0–14 years. Children in this age group comprised 5% of all people living with HIV in 23 focus countries but accounted for 15% of people who died from AIDS-related illnesses in those countries in 2018. 

"We know how to prevent children from contracting HIV, and we know how to prevent the onset of AIDS in children if they do become infected. They need to be tested and linked to care and treatment as a matter of urgency, but we are missing these opportunities,” said Henrietta Fore, Executive Director of the United Nations Children’s Fund. “Knowing what to do is not enough. We must come together and act with renewed commitment to children and adolescents living with HIV and give them the best chance to survive and thrive.”    

For optimal outcomes, children who become infected with HIV must access treatment as quickly as possible. However, in 2018, only 63% of the 1.1 million infants exposed to HIV in the 23 countries worst affected by the epidemic were tested for HIV by the age of two months.

“In many ways, we as a community have settled for a substandard quality of care for children living with HIV,” said Chip Lyons, President and Chief Executive Officer, Elizabeth Glaser Pediatric AIDS Foundation, “We must not allow children to perpetually receive less than the basic standard of care we demand for adults. Especially when the ultimate consequence of that approach is that children and young people are dying of HIV at disproportionally and unacceptably high rates.”

The report also shows that the target of reducing the annual number of new HIV infections among young women and adolescent girls aged 15–24 years to less than 100 000 by 2020 is unlikely to be reached. Globally, new HIV infections among young women and adolescent girls were reduced by 25% between 2010 and 2018, to 310 000. While new HIV infections among adolescent girls and young women aged 15–24 years have declined by over 40% in Botswana, Burundi, Lesotho and South Africa, missing the global target has meant that 6000 adolescent girls and young women are still becoming infected with HIV every week.

The root factors driving the vulnerability of young women and girls to HIV infection are social, structural and behavioural and must be addressed in order to achieve sustainable prevention outcomes. Gender discrimination, gender-based violence, restricted access to opportunities and a lack of tailored services all compound their vulnerability to HIV. Effective responses prioritize an approach combining access to HIV and sexual and reproductive health services with social, structural and behavioural programmes.

“The disparity in viral load suppression rates among adolescents with HIV compared to adults is unacceptable and behoves the global community to advocate for more robust, potent antiretroviral therapy regimens for adolescents as well as to hasten efforts to prevent new infections in this critically vulnerable population,” said Fatima Tsiouris, Deputy Director of the Clinical and Training Unit and Prevention of Mother-to-Child Transmission Lead at ICAP, Columbia University.

The number of voluntary medical male circumcisions undertaken between 2015 and 2018 stood at over 11 million among all age groups, which means that at least 13 million procedures need to be carried out by 2020 in order to reach the target of voluntarily circumcising 25 million men and boys between 2015 and 2020.

UNAIDS and the United States President’s Emergency Plan for AIDS Relief launched the Start Free, Stay Free, AIDS Free framework in 2016 to build on the achievements of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive, which ended in 2014.      

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

A newly refurbished paediatric centre is to open in Ratodero, Pakistan, to serve families affected by the recent HIV outbreak in the district of Larkana. It is expected that the centre will be operational by mid-July.     

Alia (not her real name), the mother of a two-year old girl, lives in the village of Mirpur Bhutto, in Ratodero Taluka in Larkana district.  Alia’s world has been turned upside down since her family was caught up in the HIV outbreak in the area.    

“My daughter was diagnosed with HIV just a few days ago, but she became so weak so quickly. She couldn’t eat anything we gave to her,” says Alia. After Sameera’s (not her real name) diagnosis, she was referred to Sheikh Zayed Children Hospital in Larkana to start antiretroviral therapy.  The hospital is more than 50 kilometres away from the family home.

“I got these dispersible tablets for Sameera and some fever medicine, and since she started her treatment, I have seen some improvements in my daughter’s health. Her fever has gone and before there was diarrhoea from which she also recovered,” explains Sameera’s mother.

Alia’s husband is a farmer and earns less than two dollars a day. “We can hardly support our family of ten members,” she explains.  

Poor road conditions and economic constraints make it difficult for Alia and her daughter to travel from their village to the district capital Larkana, currently the nearest health facility where her daughter can receive the treatment she needs.

Since the HIV outbreak was first reported in Larkana at the end of April, UNAIDS, UNICEF, the World Health Organization, the Sindh AIDS Control Programme and other partners have been calling for a new paediatric treatment centre in Ratodero to bring HIV services closer to the affected communities. As a result of these efforts and in the framework of the “Sindh HIV Outbreak Response Plan, May 2019-Apr 2020,” UNICEF is refurbishing the paediatric HIV treatment centre at Taluka Headquarters hospital in Rotadero, ensuring that treatment will be available in the area where Alia and her daughter live. When the new centre opens, HIV treatment services for Sameera will be less than 10 kilometres away.     

“I know my Sameera will be fine and that she will get married and have children. This is what the doctor told me. For this to happen she must continue her treatment forever.  I will follow the doctor’s instructions because this is what will save my daughter’s life,” says Alia.   

By the end of June, 877 people had been newly diagnosed with HIV in the Larkana district. More than 80% of the new cases are among children aged under 15 years old. A total of 721 people had already been registered in care programmes and 482 people (365 of them children under the age of 15) were on treatment.

“UNAIDS is working closely with the government, civil society organizations, the association of people living with HIV, UN agencies and all other partners to ensure that both the immediate response to the HIV outbreak and longer-term programmatic measures will be implemented and sustained,” said Maria Elena Borromeo, UNAIDS Country Director for Pakistan and Afghanistan.

Ahmed (not his real name) is worried as he tells his story: his five-year old son Mukhtar has been newly diagnosed with HIV. Ahmed, a medical officer working in a local hospital in the city of Ratodero in southeast Pakistan, had taken Mukhtar to be tested for HIV when the local media began warning of an increase in HIV cases among children living in his area of Sindh Province.

At the end of April, following warnings from a medical practitioner in Ratodero that a number of children under his care had tested positive for HIV in a short span of time, health officials expanded HIV screening in Larkana District. After more than six weeks of testing, more than 750 people have been newly diagnosed with HIV, with children accounting for 80% of the confirmed cases. Ahmed’s son is one of them. Before the outbreak, just over 1000 children were living with HIV in the entire country. Although further investigations are being conducted to uncover the cause of the outbreak, experts say that poor infection control practices including a lack of sterilization and the re-use of syringes and drips, could be a factor.   

Mukhtar sits quietly in his father’s lap, as Ahmed continues to tell his story.

“When I told my wife, she started to ask me questions, where did this come from, why has this happened to my child and will my child survive.” Anxiety and fear have grown in Ahmed’s family and across the province.  Every day, hundreds of parents line up outside the screening sites and pour into hospitals and clinics to get their children tested. Many of them have little understanding of HIV.

As an immediate response to the outbreak, the Sindh AIDS Control Programme (SACP) has been carrying out a major testing campaign by expanding HIV testing hubs and establishing a new HIV testing facility at the Taluka Headquarter Hospital in Ratodero. These measures have enabled more than 26 000 people to be tested, mostly children.  Sindh’s Ministry of Health has also strengthened its efforts to prevent   unlicensed and informal medical practices from operating and, as a result, 900 health clinics and unlicensed blood banks have been closed.

To ensure immediate access to HIV treatment, a new antiretroviral treatment clinic for children has been established in Larkana and additional health care providers have been deployed. These efforts are saving lives, as 356 people, including Ahmed’s son, have already been enrolled in HIV care services and started antiretroviral therapy. “I was scared but then my child got the treatment he needed,” says Ahmed. “Now we need to ensure that ARV treatment will continue to be available in our district”.

The United Nations in Pakistan is working closely with the federal and provincial governments to provide on-site technical support to help local partners effectively respond to the HIV outbreak and reduce the impact of the crisis. With the full participation of the World Health Organization,  UNICEF, UNAIDS, UNFPA and other UN agencies, the United Nations is providing support for the implementation of the “Sindh HIV Outbreak Response Plan, May 2019-Apr 2020”, which includes short-term  and long-term steps to identify the causes of the HIV outbreak, address them and strengthen the continuum of HIV prevention, treatment, care and support services.

A team comprised of SACP and other national partners with support from the United Nations acted as first responders. Subsequently, international support and expertise was brought in at the request of the federal government, to carry out an epidemiological investigation to understand the source, extent and chain of HIV transmission and provide recommendations. The investigation, whose preliminary findings will be presented on June 14, is led by the WHO with support from the Aga Khan University (AKU), the Field Epidemiology and Laboratory Training (FELTP) Programme, UNAIDS, UNICEF, the Dow Medical University in Karachi, Microbiology Society of Infectious Disease in Pakistan. 

The United Nations is also supporting national partners to develop a community response plan which will engage communities at all levels to reduce prevailing stigma and discrimination and promote health education. SACP will train health workers on paediatric case management and awareness and health education sessions will be organized with the involvement of community led organizations and religious leaders. Training sessions for local media on responsible HIV reporting and coverage will also be carried out. “We need to make sure that the root causes of this outbreak are tackled to prevent such tragedies from happening again,” says Ahmed.

With 20 000 new HIV infections in 2017, Pakistan has the second fastest growing AIDS epidemic in the Asia Pacific region, with the virus disproportionately affecting the most vulnerable and marginalized, especially key populations. UNAIDS continues to advocate for a strengthened response to the epidemic.

“We need ongoing work with national and international stakeholders to effectively address the critical gaps in preventing new HIV infections and to guarantee the health and well-being of all people living with HIV in Pakistan, so that the country is not left behind in the effort to end AIDS,” says Maria Elena F. Borromeo, UNAIDS Country Director in Pakistan.  

The earlier that a baby who has been born with HIV is diagnosed and starts treatment, the better the outcome.

To diagnose children younger than 18 months of age with HIV requires virological testing, which detects the virus or its components. Serological testing―which tests for HIV antigen and/or antibody generated as part of the immune response to infection―is used for children older than 18 months and adults. Serological testing cannot be used for infants, since it can’t differentiate between HIV antibody produced by the mother and then passed to her baby during the pregnancy, with the baby remaining uninfected, and HIV antibody produced by an HIV-infected baby.

Virological testing is not consistently available in most low- and middle-income countries, however, and when it is available it is often expensive and time-consuming, involving several clinic visits for mothers and infants, the transport of samples to centralized laboratories and potential delays in the return of results.

Globally, only half of infants who are exposed to HIV during pregnancy are tested before eight weeks of age. Since mortality among untreated infants is highest in the first three months of life, prompt diagnosis and linkage to treatment are crucial.

DAKAR/GENEVA, 16 January 2019—At a high-level meeting in Dakar, Senegal, UNAIDS, the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) urged countries in western and central Africa to do more to stop new HIV infections among children and adolescents and increase HIV testing and treatment coverage.

In 2017, around 67 000 children (aged 0–9 years) and 69 000 adolescents (aged 10–19 years) became newly infected with HIV. Two thirds (46 000) of adolescents newly infected with the virus were girls. While progress has been seen in stopping new HIV infections among children in some countries—eleven countries registered a reduction of more than 35% between 2010 and 2017[1]—others, including Nigeria, which has the largest epidemic in the region, experienced no declines at all.

“Countries in western and central Africa have a real opportunity to create a positive change for children and young people,” said Michel Sidibé, Executive Director of UNAIDS. “Underlying issues including a lack of domestic investment, fragile health systems, user fees, gender inequality and widespread stigma and discrimination must urgently be addressed to remove barriers and save lives.”

In western and central Africa, close to 800 000 children and adolescents aged between 0 and 19 years were living with HIV in 2017—the second highest number in the world after eastern and southern Africa.

“The majority of children living with HIV in this region are not receiving care and treatment because they do not know they have HIV as they have not been tested,” said Marie-Pierre Poirier, UNICEF Regional Director for West and Central Africa. “We can reverse that trend by focusing on a family-centered approach to HIV testing and treatment and by rolling out innovative point-of-care technologies that bring testing closer to the primary health facilities and the communities where children live.”

Less than half of all pregnant women living with HIV in the region (47%) had access to antiretroviral medicines to prevent transmission of the virus to their child and only 21% of infants exposed to HIV were tested for the virus within the first two months of life.

We should not lose anymore of Africa’s future to AIDS,” said Matshidiso Moeti, WHO Regional Director for Africa. “Effectively tackling HIV in children and adolescents needs strong and quality health services. By committing to universal health coverage, countries can fast-track progress towards an AIDS-free generation in western and central Africa.”

Although there has been some progress in antiretroviral therapy coverage for children in western and central Africa, which rose from 18% in 2014 to 26% in 2017, the region still has the lowest coverage in the world. Around 52 000 children and adolescents aged between 0 and 19 years died of AIDS-related illnesses in 2017—34 000 of whom died before they reached their fifth birthday.

In the 2016 United Nations General Assembly Political Declaration on Ending AIDS, countries from western and central Africa committed to work towards reducing the number of new HIV infections among children and young adolescents (under 15 years) to 6000 by 2020 and to ensuring access to treatment for 340 000 children and young adolescents (under 15 years) by 2020.

However, pledges to accelerate the HIV response have not been accompanied by a surge in resource mobilization. The total resources needed for an effective response in western and central Africa were 81% greater than the funds available in 2017.

Translating commitments into action requires engagement from political and community leaders, drastically scaling up investments, scaling up innovative technologies such as point-of-care for early infant diagnosis, differentiated service delivery strategies—including family testing and longer prescriptions for antiretroviral medicines—and task-shifting approaches applied to HIV care and treatment services for children across the region.

As part of concerted efforts to step up progress in the region, UNAIDS, UNICEF and WHO called a High-Level Meeting on the Elimination of Mother-to-Child Transmission of HIV and Universal Health Coverage of Paediatric HIV Testing and Treatment in West and Central Africa to unpack the challenges, share best practices and innovative approaches to address the persisting bottlenecks, agree on corrective actions and ensure commitment to action from countries and partners.

Hosted by the Government of Senegal, the meeting is being held in Dakar from 16 to 18 January 2019, bringing together ministers of health, experts, representatives of civil society and partners from across the region as well as high-level representatives of United Nations organizations, the African Union, the Economic Community of West African States and the Economic Community of Central African States.

During the meeting, countries and partners are expected to renew their commitment to the 2015 Dakar Call to Action for Accelerating the Elimination of New HIV Infections in Children and Access to Treatment for Children and Adolescents Living with HIV by 2020.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Faith-based organizations have long played a critical role in the response to tuberculosis (TB). Many faith-based health service providers have implemented effective TB/HIV responses modelled on decades of work on TB. Today, faith-based organizations are delivering effective, high-quality TB/HIV services that complement national public health programmes in the countries most affected by TB and HIV.

Successful TB/HIV responses address both the biomedical and the social determinants that underpin these illnesses, such as poverty, inequality, situations of conflict and crisis, compromised human rights and criminalization. Children and adolescents are particularly vulnerable to infection and the impact of TB/HIV on their families. Because they have positions of trust at the heart of communities, faith-based organizations can provide services and support that extend beyond the reach of many public sector health systems.

To provide an opportunity to strengthen relationships and forge new partnerships, on 27 September the World Council of Churches–Ecumenical Advocacy Alliance, in collaboration with UNAIDS, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the United Nations Interagency Task Force on Religion and Development, hosted an interfaith prayer breakfast on the sidelines of the 73rd Session of the United Nations General Assembly in New York, United States of America. Keynote speakers and table discussions focused on the outcomes of the United Nations High-Level Meeting on Tuberculosis, which took place on 26 September, and examined how the longstanding experience of faith-based organizations in responding to TB/HIV can support the new declarations agreed by Member States during the historic high-level meeting.

The participants included faith leaders and health service providers from different religious traditions. Survivors of multidrug-resistant TB brought a powerful sense of urgency and reality to the discussion. The participants renewed their call to national governments to not only maintain, but increase, support in order to end AIDS and TB as public health threats by 2030.