Preventing mother to child transmission

Naomi Watts, UNAIDS Goodwill Ambassador, visited Nyumbani Children’s Home in Kenya on 11 July to learn about Kenya’s prevention of mother-to-child transmission of HIV programme and the work done in the home to care for children living with HIV.

In the space of just a few years, as the result of a strong partnership between political leadership, programme implementers and the community, new HIV infections among children aged 0–14 years in Kenya have fallen from 12 000 in 2013 to 6600 in 2015. In June, under the leadership of the First Lady, Margaret Kenyatta, Kenya launched a new framework to accelerate the country’s efforts towards elimination of mother-to-child transmission of HIV and syphilis. The framework calls for the elimination of stigma and discrimination and the creation of an environment that empowers women living with HIV.

Nyumbani Children’s Home opened in 1992 and is currently home to 124 children living with HIV. The home provides nutritional, medical, psychosocial and spiritual care to the children and to the surrounding community, providing a place of safety in Nairobi for abandoned children living with HIV. In addition, the organization has a community- based programme that supports more than 3100 children living with HIV who reside in the informal settlements of Nairobi and 1000 orphans in Nyumbani villages.

Mss Watts and her two sons visited several facilities in the home, including its state-of-art laboratory equipped to undertake early infant diagnosis and viral load testing. Ms Watts congratulated Nyumbani Children’s Home for the impact it makes on a daily basis in the lives of so many remarkable and empowered children. She committed to continue to create awareness of the need to ensure that children living with HIV remain AIDS-free. 

The steady scale up and improvement of services to prevent mother-to-child transmission of HIV has reduced the annual number of new infections among children globally by 56% since 2010 and by 70% since 2000. Since 1995, an estimated 1.6 million new HIV infections among children have been averted due to the provision of antiretroviral medicines to women living with HIV during pregnancy or breastfeeding. The vast majority of these infections (1.3 million) were averted between 2010 and 2015. Complex challenges remain, however, to achieve the elimination of mother-to-child transmission of HIV.

At the 21st International AIDS Conference in Durban, South Africa, stakeholders came together on 18 July to forge ahead on the Start Free, Stay Free, AIDS Free initiative, which was launched at the United Nations General Assembly High-Level Meeting on Ending AIDS in June 2016. The initiative is designed as a follow-up to the remarkable success achieved by the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive.

In a session entitled “Start Free, Stay Free, AIDS Free: finishing the job of the Global Plan,” stakeholders reviewed the progress made towards eliminating new HIV infections among children, as well as how to super Fast-Track access to paediatric treatment for mothers and children. The session was organized by a consortium comprising UNAIDS, the United States President’s Emergency Plan For AIDS Relief (PEPFAR), the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO).

The Start Free, Stay Free, AIDS Free framework provides a menu of policy and programmatic actions designed to enable countries and partners to close the remaining HIV prevention and treatment gap for children, adolescents, young women and expectant mothers. Stakeholders discussed how to build a concerted and coordinated country-led action that is backed by global support, so that countries can move quickly forward. The framework recognizes that every country needs a tailor-made acceleration and implementation plan. Each plan should respond to the country context, building on successful strategies for systems strengthening and identifying critical opportunities and actions that can expand access to life-saving HIV treatment and prevention services for all children, adolescents and young women as quickly as possible.

Participants at the session discussed the need to ensure that children are at the centre of an AIDS-free generation and examined the major barriers, gaps and opportunities to achieving this goal. The session also discussed the role of public–private partnerships and women living with HIV.

Speakers included the Executive Director of UNAIDS, Michel Sidibé, Deborah Birx, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy, Chip Lyons, Executive Director of the Elizabeth Glaser Pediatric AIDS Foundation, Anthony Lake, the Executive Director of UNICEF, and Gottfried Hirnschall of WHO. Speakers also included representatives of private sector organizations, such as the MAC AIDS Fund, Johnson & Johnson and Born Free.

The Start Free, Stay Free, AIDS Free framework establishes three blocks of programme activity that are closely interrelated and should move forwards together. The participants discussed how to ensure that the response takes into account the reality and variability of country, government and partner priorities, and how to create an implementation environment that optimizes partnerships. They discussed the role of accountability and measurement and mechanisms to ensure that countries get timely responses and support. To support implementation, the framework also calls on industry, civil society and international partners to focus on investing in and finding new, efficient and cost-effective solutions that simplify and innovate to maximize programme outcomes.

Concerted global efforts have led to a 60% drop in new infections among children, which has averted 1.2 million new HIV infections among children in 21 priority countries since 2009

NEW YORK/GENEVA, 8 June 2016—UNAIDS and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) announced today that there has been a 60% decline in new HIV infections among children since 2009 in the 21 countries in sub-Saharan Africa that have been most affected by the epidemic.

New HIV infections among children in the 21 countries dropped from 270 000 [230 000–330 000] in 2009 to 110 000 [78 000–150 000] in 2015. Equally impressive are gains made in bridging the treatment gap among children. In 2005, fewer than one in 10 children had access to antiretroviral treatment—this gap has now been reduced to one in two. In the past five years alone, treatment scale-up for children grew twofold. The impact is that AIDS-related deaths among children were reduced by 44%.

“These astounding results show that the world is on the Fast-Track to eliminating new HIV infections among children and ensuring that their mothers are alive and healthy,” said UNAIDS Executive Director Michel Sidibé. “It’s beautiful to know that we could soon have a new generation free from HIV.”

The results were published in a new report, On the Fast-Track to an AIDS-free generation, which was launched at an event hosted by UNAIDS and PEPFAR on the opening day of the United Nations General Assembly High-Level Meeting on Ending AIDS, taking place in New York, United States of America, from 8 to 10 June.

“This shows what is possible through the combined power of science, communities and focused action,” said Deborah Birx, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy. “PEPFAR is building on this success, driving harder and smarter to prevent HIV infections and end AIDS among children, adolescents and young women through our DREAMS Partnership, Accelerating Children’s HIV/AIDS Treatment initiative and other efforts.”

During the event, UNAIDS also released global data for children that showed that new HIV infections among children have declined globally by 50% since 2010—down from 290 000 in 2010 to 150 000 in 2015. It also showed that 49% of children living with HIV around the world now have access to life-saving treatment. On the eve of the event, UNAIDS and partners announced that Armenia, Belarus and Thailand have joined Cuba in receiving official certificates of validation from the World Health Organization for eliminating new HIV infections among children. Thailand is the first country with a major HIV epidemic (450 000 people living with HIV in 2014) to receive such a validation.

It was during the High-Level Meeting on HIV and AIDS in 2011 that UNAIDS and PEPFAR joined with partners to launch the Global Plan towards the elimination new HIV infections among children by 2015 and keeping their mothers alive (Global Plan). The focus of the Global Plan was to increase efforts to prevent new HIV infections in all countries, but particularly in the 22 countries that, in 2009, accounted for 90% of pregnant women living with HIV.

The new report released today shows the progress made since the Global Plan was launched. It outlines that seven countries have reduced new HIV infections among children by more than 70% since 2009 (the baseline for the Global Plan), including: Uganda, by 86%; South Africa and Burundi, by 84%; Swaziland, by 80%; Namibia, by 79%; Mozambique, by 75%; and Malawi, by 71%. In Nigeria, however, the decline was much smaller, at just 21%. In India, the only Global Plan country outside of sub-Saharan Africa, new HIV infections in children dropped by 44% and coverage of services to pregnant women increased from less than 4% in 2010 to 31% in 2015. 

The new report demonstrates that treatment or prophylaxis (excluding the less-effective single-dose nevirapine) coverage for pregnant women living with HIV in the countries most affected by the epidemic increased dramatically from 2009. By 2015, more than 80% of pregnant women living with HIV in the 21 countries in sub-Saharan Africa had access to medicines to prevent transmission of the virus to their child—up from just 36% (excluding the less-effective single-dose nevirapine) in 2009.

The World Health Organization recommends that all pregnant women living with HIV should be offered lifelong HIV treatment, extending beyond Option B+ to include all women diagnosed with HIV regardless of pregnancy. By 2015, all of the Global Plan countries, with the exception of Nigeria, were routinely offering lifelong HIV treatment to all pregnant women living with HIV. The massive scale-up of treatment has helped to reduce AIDS-related deaths among women of reproductive age, which declined by 43% between 2009 and 2015.  

Incredible journey

Six countries—Botswana, Mozambique, Namibia, South Africa, Swaziland and Uganda—met the Global Plan goal of ensuring that 90% or more of pregnant women living with HIV had access to life-saving antiretroviral medicines. Six additional countries provided antiretroviral medicines to more than 80% of pregnant women living with HIV—Burundi, Cameroon, Malawi, the United Republic of Tanzania, Zambia and Zimbabwe.

Major successes have also been seen in increasing access to treatment for children living with HIV in the 21 countries: access has increased more than threefold since 2009—from 15% in 2009 to 51% in 2015. However, this is still only half of all children in need of treatment. Major efforts are required to ensure that all children born to HIV-positive mothers are tested for HIV within the first two months of life. Without immediate access to treatment, around 30% of children living with HIV will die within the first year of life and more than 50% will die before they reach their fifth birthday.

The Global Plan also aspired to reduce new HIV infections among women of reproductive age by 50%. The actual decline was just 5%—well below the target. This suggests that women, including young women, continue to be left behind and are not being reached with HIV prevention services. Between 2009 and 2015, around 4.5 million [3.8 million–5.4 million] women became newly infected with HIV in the 21 priority countries in sub-Saharan Africa, and AIDS-related illnesses remain the leading cause of death among adolescents on the continent.

At the launch of the report, UNAIDS, PEPFAR and partners also launched a Super Fast-Track framework for ending AIDS among children, adolescents and young women—Start Free, Stay Free, AIDS-Free. The initiative will build on the progress already made to Fast-Track action to end the AIDS epidemic and sets ambitious targets to eliminate new infections among children, find and ensure access to treatment for all children living with HIV and prevent new HIV infections among adolescents and young women. Together, these steps will put the world on a path to ending AIDS among children.

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.

PEPFAR

The United States President’s Emergency Plan for AIDS Relief (PEPFAR) is the United States Government initiative to save the lives of those affected by HIV/AIDS around the world. This historic commitment is the largest by any nation to combat a single disease internationally, and PEPFAR investments also help alleviate suffering from other diseases across the global health spectrum. PEPFAR is driven by a shared responsibility among donor and partner nations and others to make smart investments to save lives. Learn more at pepfar.gov and connect with us on Facebook and Twitter.

NEW DELHI/BANGKOK, 7 June 2016— Thailand today received validation from WHO for having eliminated mother-to-child transmission of HIV and syphilis, becoming the first country in Asia and the Pacific region and also the first with a large HIV epidemic to ensure an AIDS-free generation.  The Minister of Health of Thailand was presented with the certificate of validation during a ceremony which took place in New York on the eve of the United Nations General-Assembly High-Level Meeting on Ending AIDS.

 “This is a remarkable achievement for a country where thousands of people live with HIV. Thailand’s unwavering commitment to core public health principles has made elimination of mother-to-child transmission of HIV and syphilis a reality, a critical step for rolling back the HIV epidemic. Thailand has demonstrated to the world that HIV can be defeated,” Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region, said presenting the certificate of validation to Thailand in New York.

"Thailand has turned around its epidemic and transformed the lives of thousands of women and children affected by HIV," said UNAIDS Executive Director, Michel Sidibé. "Thailand's progress shows how much can be achieved when science and medicine are underpinned by sustained political commitment."

"By investing in strong maternal and child health care and national AIDS prevention measures, Thailand has demonstrated there are ways to protect children from the global AIDS pandemic response,” said Karin Hulshof, Regional Director, UNICEF East Asia-Pacific Region. “Thailand’s achievement inspires its neighbours to greater action. There are still 21,000 infants who are born with HIV each year in the Asia-Pacific region, and more than 200,000 children who are growing up with HIV.”

Untreated, women living with HIV have a 15-45% chance of transmitting the virus to their children during pregnancy, labour, delivery or breastfeeding. However, that risk drops to just over 1% if antiretroviral medicines are given to both mothers and children throughout the stages when infection can occur.

According to Thailand’s Ministry of Public Health 98% of all pregnant women living with HIV have access to antiretroviral therapy and the rate of mother-to-child transmission of HIV has been reduced to less than 2%. In 2000, an estimated 1000 children became infected with HIV. In 2015, the number of children who became infected with HIV through mother to child transmission was reduced to 85, a decline of more than 90%, a significant achievement in a country where an estimated 450 000 people were living with HIV in 2014.

At the same time, sustained efforts and success in preventing new HIV infections have helped reduce HIV among women of childbearing age. According to Thailand’s health authorities, between 2000 and 2014, the annual number of women newly infected with HIV fell from 15 000 to 1 900 – a 87% reduction. Thailand’s Universal Health Coverage framework ensured essential health services were available to both rich and poor. The country’s commitment to equitable access has ensured that both Thai citizens and migrants are covered for HIV treatment.

Thailand’s commitment to the UNAIDS-led ‘Global Plan towards the elimination of new HIV Infections among children by 2015 and keeping their mothers alive’, combined with the Government’s decision to provide all pregnant women – including documented and undocumented migrant workers – free antenatal care, delivery and services for HIV and syphilis pushed treatment coverage rates up, culminating in validation of elimination of mother-to-child transmission.

Thailand’s pioneering success and leadership demonstrates how countries can make real change when good policy is followed up with high-level commitment. WHO, UNAIDS and UNICEF will continue to work with other countries in the region, along with partners to replicate Thailand’s success.

WHO validation process

In 2014, WHO and key partners published the guidance on global processes and criteria for the validation of the elimination of mother-to-child transmission of HIV and syphilis, which outlines the validation process and the different indicators countries need to meet.

As treatment for prevention of mother-to-child-transmission is not 100% effective, elimination of transmission is defined as a reduction of transmission to such a low level that it no longer constitutes a public health problem.

An international expert mission convened by WHO visited Thailand in April 2016 to validate the progress toward the elimination of mother-to-child transmission of HIV and syphilis. The members visited health centres, laboratories, and government offices, and interviewed health officials and other key actors. The mission included experts from Australia, Cambodia, China, Philippines, India, Indonesia, Nepal, Thailand, United States and representatives from WHO, UNICEF and UNAIDS.

Video on Thailand's success:  https://www.youtube.com/watch?v=eVIh3pnnOh4&feature=youtu.be

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.

COPENHAGEN/GENEVA/ISTANBUL, 7 June 2016—United Nations agencies congratulate Belarus for eliminating mother-to-child transmission of both HIV and syphilis and Armenia and the Republic of Moldova for eliminating mother-to-child transmission of HIV and syphilis, respectively. During a ceremony in New York City, elimination validation certificates were presented to the ministers of health of the three European countries, who were attending the United Nations General Assembly High-level Meeting on Ending AIDS.

“To ensure children are born healthy is to give them the best possible start in life. It is immensely encouraging to see countries succeed in eliminating mother-to-child transmission of these two diseases,” said WHO Director-General Dr Margaret Chan. “This is a tremendous achievement – a clear signal to other countries that elimination is possible and that the world is on the way to an AIDS-free generation.” Ending the epidemics of AIDS by 2030 is a key target of the Sustainable Development Goal on health and well-being.

“Every child growing up free from HIV thanks to antiretroviral medicines is a testimony to the progress the world is making in eliminating mother-to-child transmission of HIV," said UNAIDS Executive Director Michel Sidibé. “As we meet in New York at the High-level Meeting on Ending AIDS to plan the next, crucial phase of the response to HIV, we will draw upon the successes of these countries to highlight the extraordinary achievements that can be made through the rapid expansion of access to life-saving treatment.”

Achievements in Armenia, Belarus and the Republic of Moldova

The World Health Organization (WHO) has been working in Armenia, Belarus and the Republic of Moldova since 2010 with the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Children's Fund (UNICEF) and the United Nations Population Fund (UNFPA) to eliminate mother-to-child transmission of HIV and syphilis.

“This is a success for these countries and a celebration for children and families. We expect that these achievements will inspire many other European countries to seek validation that they have ended mother-to-child transmission of HIV and syphilis,” added Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “It is only by ensuring truly universal access to HIV and syphilis prevention, treatment and care for all, while respecting individual rights, that the HIV and syphilis epidemics in children will be eliminated.”

“After two decades of intensive efforts in the Region, we now have validated proof that it is possible to realize the right of all children to be born HIV-free. As we move forward, it is important that children have equitable access to services that can help them thrive and develop in a supportive family environment, with their mothers alive and nurturing their well-being,” said Marie-Pierre Poirier, UNICEF Regional Director for Europe and Central Asia.

Depending on the progress of national efforts, countries may choose validation of the elimination of mother-to-child transmission of HIV, syphilis or both. Armenia, Belarus and the Republic of Moldova have worked to ensure early universal access to free services for antenatal care, HIV and syphilis testing for pregnant women and their partners, treatment for women who test positive, early diagnosis in infants, free infant formula and community engagement. These services are provided as part of an equitable, accessible, universal health system in which maternal and child health programmes are integrated with programmes for HIV and sexually transmitted infections.

“The remarkable achievements of these countries in eliminating HIV and syphilis transmission to infants underscore the importance of robust maternal health services,” according to Dr Babatunde Osotimehin, Executive Director, UNFPA. “Only by offering pregnant women integrated HIV and syphilis care as part of a rights-based, comprehensive package of sexual and reproductive health services, including family planning, can we truly keep the mother–baby pair alive and thriving.” The validation process for the three countries was conducted by WHO in collaboration with UNAIDS, UNICEF and UNFPA.

Europe’s progress in reducing mother-to-child transmission of HIV and syphilis

The reduction in the number of new cases of HIV and congenital syphilis infections among children is one of Europe’s successes in its response to HIV and sexually transmitted infections in the past few years. Mother-to-child transmission accounted for just 1% of new cases of HIV infection reported in 2014 in the WHO European Region.

Ensuring that pregnant women living with HIV and their children have access to antiretroviral therapy lowers the risk of mother-to-child transmission of HIV from up to 45% to 1%. Up to 95% of HIV-infected pregnant women receive antiretroviral therapy in Europe – the highest percentage globally, and more than 70% of infants of HIV-positive women were tested within two months of birth.

Screening and treatment during pregnancy are essential to prevent mother-to-child transmission of syphilis, which can cause miscarriage, stillbirth or neonatal death in up to 80% of cases. Over 60% of European countries offer syphilis testing to pregnant women, and all countries in the Region offer free treatment to syphilis-infected pregnant women.

WHO support to European countries

WHO has been supporting European countries in eliminating mother-to-child transmission by providing guidance on the use of antiretroviral drugs and on validation criteria and processes of elimination of mother-to-child transmission of HIV and syphilis.

Two regional consultations in 2015 reviewed progress, addressed the remaining challenges and recommended actions to accelerate efforts towards elimination of mother-to-child transmission of HIV and syphilis as well as validation of their elimination.

Through a new action plan on HIV response, WHO will continue to support countries in the WHO European Region in their efforts to eliminate mother-to-child transmission of HIV and syphilis by 2030.

Notes to editors

• As treatment for prevention of mother-to-child-transmission is not 100% effective, elimination of transmission is defined as a reduction in transmission to such a low level that it no longer constitutes a public health problem.
• The term “validation” is used to attest that a country has successfully met the criteria for eliminating mother-to-child transmission of HIV and/or syphilis at a specific time; countries are required to maintain ongoing programmes.

Links

• Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection http://www.who.int/hiv/pub/guidelines/arv2013/en/
• Guidance on global processes and criteria for validation of elimination of mother-to-child transmission of HIV and syphilis http://www.who.int/reproductivehealth/publications/rtis/9789241505888/en/
• Methods for surveillance and monitoring of congenital syphilis elimination within existing systems http://www.who.int/reproductivehealth/publications/rtis/9789241503020/en/
• The global elimination of congenital syphilis: rationale and strategy for action http://www.who.int/reproductivehealth/publications/rtis/9789241595858/en/
• WHO/Europe HIV http://www.euro.who.int/en/health-topics/communicable-diseases/hivaids
• WHO/Headquarters HIV http://www.who.int/hiv/en
• UNAIDS http://www.unaids.org/en/
• UNICEF HIV http://www.unicef.org/aids/
• UNFPA http://eeca.unfpa.org

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.

At a special event at the Royal Scottish Geographical Society, UNAIDS International Goodwill Ambassador Annie Lennox has been awarded the prestigious Livingstone Medal for her outstanding contribution to humanitarian work, including her work in the response to HIV.

For more than two decades, Ms Lennox has used her platform to respond to the stigma and discrimination associated with HIV, spoken out for the most vulnerable people in society and been a powerful voice for the empowerment of women and girls. She has undertaken numerous visits to affected communities in Africa and supports many nongovernmental organizations, such as mothers2mothers, which campaigns to end HIV among children. Ms Lennox has been an International Goodwill Ambassador for UNAIDS since 2010.

Awarded since 1901 and named after the nineteenth century British explorer David Livingstone, former recipients of the Livingstone Medal include the American astronaut Neil Armstrong, the New Zealand mountaineer Sir Edmund Hillary and the former Irish President and United Nations High Commissioner for Human Rights, Mary Robinson.

Africa–China Partnership: Caring for an AIDS-Free Generation launched on the sidelines of the Forum for China–Africa Cooperation in Johannesburg

JOHANNESBURG, 5 December 2015—The Organisation of African First Ladies against HIV/AIDS (OAFLA), along with Peng Liyuan, First Lady of China, today reaffirmed their commitment to an AIDS-free generation. The OAFLA Africa–China HIV advocacy event took place on the sidelines of the Forum for China–Africa Cooperation Heads of State Summit in Johannesburg, South Africa.

“We need to take advantage of our privileged positions as First Ladies to advocate with our people, and especially our youth, to ensure everyone takes responsibility for their health and has access to adequate services,” said Tobeka Madiba Zuma, First Lady of South Africa.

Keeping in line with the OAFLA focus on maternal and child health, discussions during the event focused on further reducing new HIV infections among children in Africa and China, and ensuring that all children, their mothers and pregnant women living with HIV have access to antiretroviral therapy. 

“This is the start of a long and fruitful partnership between Africa and China towards achieving an AIDS-free generation,” said Nana Lordina Dramani Mahama, First Lady of Ghana and President of OAFLA. “We must continue to expand prevention of mother-to-child HIV transmission programmes to ensure universal access to HIV treatment for all women and children. We will work hand-in-hand to secure a beautiful partnership for an AIDS-free generation.”

Both Africa and China have dramatically scaled up their prevention of mother-to-child HIV transmission programmes and produced impressive results. Seven African countries have rapidly reduced new HIV infections among children by 60% or more, and a further seven have experience a 30-60% decline.

Michel Sidibé, UNAIDS Executive Director, urged the First Ladies of OAFLA and China to continue their high level advocacy on HIV. “This meeting is happening at a great moment,” said Mr Sidibe. “It is just one day after President Xi laid out a new partnership between China and Africa that will enable us to have a generation free from HIV.  It is also important because we are together―and I know that the First Ladies have been fighting for a long time to be a voice for the voiceless.”

The First Ladies highlighted that HIV treatment programmes are leaving children far behind. They reiterated that urgent action is needed to accelerate the HIV treatment response among children. Without treatment, half of children living with HIV will die before their second birthday.

Peng Liyuan, First Lady of China, related four key issues critical to ending AIDS by 2030: universal access to HIV treatment; public information and education; educational opportunities for adolescents; and economic development to eliminate poverty. She reiterated China’s support to address HIV in Africa, especially maternal and child health. “As long as the international community works together we will be able to realize an AIDS-free world,” she added.

The First Ladies are extremely important advocates and very influential,” said Margaret Chan, Director-General of the World Health Organization. “They must continue to advocate for an AIDS-free generation and we will be there to support them.”

The First Ladies of Africa and China will join forces to achieve an AIDS-free generation by sharing information, helping each other to build expertise, and mobilizing resources for joint advocacy to support women and children living with and affected by HIV.

Aaron Motsoaledi, Minister of Health of South Africa, and Gertrude Mutharika, First Lady of Malawi and Vice-President of OAFLA, joined the panellists in pledging their support to reach the Fast-Track Targets to end the AIDS epidemic as a public health threat by 2030.

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 to end the AIDS epidemic by 2030 as part of the Sustainable  Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter and Instagram.

Tobeka Madiba Zuma Foundation

The Tobeka Madiba Zuma Foundation, founded in 2009, advocates for prevention, treatment and care of non-communicable diseases, a #cancersmart South Africa, and HIV prevention, treatment and care. For more information follow TMZ Foundation on Facebook, Twitter and Instagram.