June 2021

EGPAF statement on the 2021 Political Declaration

June 10, 2021, Washington, DC – The Elizabeth Glaser Pediatric AIDS Foundation applauds the adoption of the 2021 Political Declaration on HIV and AIDS this week and welcomes the inclusion of a new global pledge to eliminate vertical transmission of HIV and end pediatric AIDS by 2025.

The 2021 Political Declaration challenges UN member states to take meaningful action on pediatric HIV and keep children at the top of the development agenda, noting with alarm the deep inequalities faced by children living with the virus. Although children accounted for 5% of people living with HIV in 2019, they represented 14% of all AIDS-related deaths. New HIV infections in children continue to be unacceptably high: 150,000 children were vertically infected with HIV in 2019 compared to the 2020 target of 20,000, and alarmingly 47 % of children living with HIV globally – two thirds of whom are 5 years old or older – do not have access to live-saving treatment.

The Declaration provides an opportunity to re-energize political momentum and leadership, including securing sufficient funding, to achieve the new goals to reduce the impact of AIDS on pregnant women, children, and youth – all of which must be achieved in the context of addressing stigma, structural and human rights barriers.

Without a voice in the global AIDS response, children have an unequal opportunity to call for solutions to their needs. It falls to us to put children forward, preventing them from once again being left behind – and this political declaration is a clear step forward on their behalf. Chip Lyons, EGPAF CEO and President

Key pediatric commitments made by world leaders include:

  • Achieving the 95-95-95 testing, treatment and viral suppression targets within all demographics and groups and geographic settings, including children and adolescents living with HIV;
  • Utilizing multiple effective HIV testing technologies and approaches, including point-of-care early infant diagnosis and HIV self-testing, and rapidly initiate people on treatment shortly after diagnosis;
  • Eliminating vertical transmission of HIV infections and end pediatric AIDS by 2025;
  • Ensuring by 2025 that 95 per cent of pregnant women have access to antenatal testing for HIV, syphilis, hepatitis B and other sexually transmitted infections, 95 per cent of pregnant and breastfeeding women have access to re-testing, and that all pregnant and breastfeeding women living with HIV are receiving life-long antiretroviral therapy, with 95 per cent achieving and sustaining viral suppression before delivery and during breastfeeding;
  • Ensuring by 2025 that all HIV-negative pregnant and breastfeeding women have access to combination prevention, including pre-exposure prophylaxis;
  • Testing 95 per cent of HIV-exposed children by two months of age and after the cessation of breastfeeding, ensuring that all children diagnosed with HIV are provided treatment regimens and formulas optimized to their needs, and ensuring that 75 per cent of all children living with HIV have suppressed viral loads by 2023 and 86 per cent by 2025, in line with the 95–95–95 targets;
  • Identifying and treating undiagnosed older children, including adolescents, and providing all children and adolescents living with HIV with a continuum of developmentally appropriate care and social protection;

While adopting the new commitments is a significant step in the fight against pediatric AIDS, vigilance is required to translate words into action. Ninety percent of children living with HIV are located on the African continent, which requires an African-led, African-focused effort to achieve the ambitious targets and fulfill the promise of an AIDS-free generation. The Political Declaration sets clear targets and the basis for an urgent consultative process to develop a framework to end AIDS in children, building on the success of high-level global efforts.

Ending pediatric AIDS is both ambitious and achievable, but it will take a united, well-resourced effort by communities, governments, business, NGOs, and global health agencies to eliminate the glaring disparities in the global AIDS response which continue to impact children. EGPAF will continue to work in collaboration with actors nationally and globally to translate global commitments into local transformative and disruptive actions to accelerate efforts to end HIV in children, youth, and families.

Finally, EGPAF expresses our concern regarding critical omissions and weakened commitments regarding sexual and reproductive health and rights (SRHR) and comprehensive sexuality education, as these are critical for the fight against HIV, particularly for youth. In addition, increased substantive participation of adolescents and youth in agenda-setting, policy development, and program implementation is essential for any national HIV program expecting to successfully address the prevention, treatment, and support needs of Generation Z.