New report reveals stark inequalities in access to HIV prevention and treatment services for children—partners call for urgent action - World - ReliefWeb

Almost half (46%) of the world’s 1.7 million children living with HIV were not on treatment in 2020 and 150 000 children were newly infected with HIV, four times more than the 2020 target of 40 000.

In the final report from the Start Free, Stay Free, AIDS Free initiative, UNAIDS and partners* warn that progress towards ending AIDS among children, adolescents and young women has stalled and none of the targets for 2020 were met.

The report shows that the total number of children on treatment declined for the first time, despite the fact that nearly 800 000 children living with HIV are not currently on treatment.

Start Free, Stay Free, AIDS Free is a five-year framework that began in 2015, following on from the hugely successful Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive.

The approach intensified focus on 23 countries, 21 of which were in Africa, that accounted for 83% of the global number of pregnant women living with HIV, 80% of children living with HIV and 78% of young women aged 15–24 years newly infected with HIV.

However, there were major disparities between countries, and these countries still bear the highest burden of disease: 11 countries account for nearly 70% of the “missing children”—those living with HIV but not on treatment.

There was a 24% decline in new HIV infections among children from 2015 to 2020 in focus countries versus a 20% decline globally.

Focus countries also achieved 89% treatment coverage for pregnant women living with HIV, compared to 85% globally, but still short of the target of 95%, and there were huge differences between countries.

The report outlines three actions necessary to end new HIV infections among children in the focus countries.

First, reach pregnant women with testing and treatment as early as possible—66 000 new HIV infections occurred among children because their mothers did not receive treatment at all during pregnancy or breastfeeding.

Third, prevent new HIV infections among women who are pregnant and breastfeeding—35 000 new infections among children occurred because a woman became newly infected with HIV during pregnancy or breastfeeding.

There has been some progress in preventing adolescent girls and young women from acquiring HIV.

In the focus countries, the number of adolescent girls and young women acquiring HIV declined by 27% from 2015 to 2020.

However, the number of adolescent girls and young women acquiring HIV in the 21 focus countries was 200 000, twice the global target for 2020 (100 000).

In addition, COVID-19 and school closures are now disrupting many educational and sexual and reproductive health services for adolescent girls and young women, highlighting the urgent need to redouble HIV prevention efforts to reach young women and adolescent girls.

“The lives of the most vulnerable girls and young women hang in the balance, locked into deeply entrenched cycles of vulnerability and neglect that must urgently be interrupted.

We know that rapid gains can be achieved for girls and young women; what is needed is the courage to apply the solutions, and the discipline to implement these with rigor and scale,” said Chewe Luo, United Nations Children’s Fund Chief of HIV and Associate Director of Health Programmes.

“It is clear that ending mother-to-child transmission requires innovative approaches that support the whole woman throughout the life course, including intensified primary prevention efforts, such as pre-exposure prophylaxis (PrEP), access to comprehensive reproductive care, and focused attention on adolescent girls and young women.

The Start Free, Stay Free, AIDS Free report includes new the new targets for 2025 that, if met, will propel a new era of HIV prevention and treatment for women, children and families.

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.

Department of State, and supported through the compassion and generosity of the American people, PEPFAR has saved 20 million lives, prevented millions of infections, and helped transform the global AIDS response.