World Children’s Day Statement on Advances in Access to Paediatric HIV and TB Diagnosis and Treatments
20 November 2020—The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), the World Health Organization (WHO), the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Joint United Nations Programme on HIV/AIDS (UNAIDS), Stop TB Partnership and faith-based organizations (FBOs) are pleased to mark World Children’s Day by issuing a strong call to accelerate children’s access to effective pediatric HIV and tuberculosis (TB) diagnostics and medicines around the world. Together, we are releasing an action plan with a wide-ranging and comprehensive set of commitments.
The 2020 Rome Action Plan is the result of a virtual High-Level Dialogue on Paediatric HIV and TB in Children Living with HIV, convened by His Eminence Peter Kodwo Appiah Cardinal Turkson, Prefect of the Vatican’s Dicastery for the Promotion of Integral Human Development, on 5 – 6 November 2020, with EGPAF, WHO, PEPFAR, UNAIDS, Stop TB Partnership and FBOs. Brought together under the UNAIDS/PEPFAR Faith Initiative, this is the fifth in a series of innovative dialogues gathering leaders from the private and public sectors, governments, regulatory authorities and implementing partners for discussions centered on finding solutions to remove bottlenecks in the development, introduction, and scale-up of optimized diagnostics, prevention, and treatment for HIV and TB among children living with HIV.
The plan includes pledges from participating organizations to accelerate development of new optimal pediatric HIV and TB formulations; improved diagnostic devices and assays for children with TB; and lower prices and wider availability of tests for early infant HIV diagnosis. Regulators pledged to accept streamlined clinical trial development models for priority TB drugs, as they have for HIV medicines, and to increase collaboration across regulatory authorities in different countries to facilitate decision-making. Government representatives pledged their support for advancing widespread availability of new tests and optimal pediatric medicines.
Many of the action points of the plan promote a multi-sector approach, with greater coordination among partners. The partnership has set a new standard of what is achievable when stakeholders with shared values work collaboratively. For example, the timeline to develop the new paediatric dose of Dolutegravir was shortened by more than two years—becoming the fastest transition from adult to paediatric formulation ever approved by regulators.
Stakeholders also recommitted to using an accountability system established to oversee the two previous Rome Action Plans in 2017 and 2018, for which measurable progress has been reported.
Children are among the most underserved populations in the global response to HIV and TB. In 2019, 1.8 million children aged 0 – 14 were living with HIV, but only 52.7% of them were diagnosed and on treatment. Because of this gap in medicines and services, nearly 100,000 children died from AIDS-related causes.
Children living with HIV are particularly susceptible to TB disease, a major cause of AIDS-related deaths in this population. TB diagnostics, preventive care, and treatment are far from sufficient in access and convenience for children. As a result, in 2019, there were an estimated 36,000 children living with HIV who died from TB.
The COVID-19 pandemic has created an unprecedented disruption in HIV and TB services for children and families and threatened decades of progress made in access to pediatric testing and treatment.
During the dialogue, testimonies from mothers, doctors, and community activists illustrated the real-life impact of inadequate diagnostics and medicines. Some spoke about the heartbreak felt by parents required to give their children daily medicines that are difficult to swallow due to the taste, size, or quantity. Others described the invasive procedures small children must undergo to receive an accurate TB diagnosis, leaving a stark reminder of the countless children with undiagnosed TB or HIV, leading to their unnecessary suffering and deaths.
As we commemorate World Children’s Day, we encourage action for children’s rights and achieving the targets included in the political declarations of the UN General Assembly High-Level Meeting on tuberculosis and the High-Level meeting on ending AIDS, as well as the WHO End TB Strategy.
We recommit to building upon advancements in pediatric testing and treatment; to promote health equity, and social justice, while rising to the new challenges COVID-19 presents; and strongly reaffirm our common purpose to fight for an AIDS-free generation.
QUOTES
“We have made admirable progress with the research, development and registration of treatment formulations and dosages that are much better adapted to use with children. However, these remarkable accomplishments can only yield their greatest fruit if we redouble our efforts to work in partnership. These stronger efforts will require the cooperation of all: the governments, the private sector, the donors, the implementing partners, the non-governmental organizations, and especially the faith-based groups, which are present and rooted in the local communities where undiagnosed children are most likely to be found.” His Eminence Peter Kodwo Appiah Cardinal Turkson, Prefect of the Vatican’s Dicastery for the Promotion of Integral Human Development
“We should never accept anything less than the fact that every child should have access to be diagnosed, and receive optimal, child-friendly formulations and treatment for TB and DR-TB. At Stop TB we cannot accept that there are 700 children that each day die from TB, and we will do whatever it takes to change this situation. We call on all of you to join us!” Dr Lucica Ditiu, Executive Director of the Stop TB Partnership.
‘When reflecting on the power of this partnership to affect action and change, I am left with the age-old adage ‘When all is said and done, let’s have more done than said’. Let’s make this collaboration action oriented and focused on child-centered impact. — Mariangela Simao, ADG World Health Organization.
“The Vatican initiative has been a bright spot in the fight for an AIDS-free Generation, where a variety of stakeholders convene to focus on solutions and achieving measurable progress for children living with HIV. While COVID-19 has presented substantial challenges to treatment and access for vulnerable populations, we remain determined in our mission to see a world where no mother, child, or family is devastated by HIV and AIDS.” Chip Lyons, President and CEO of the Elizabeth Glaser Pediatric AIDS Foundation.
