Preventing New HIV Infections, Saving Lives

Globally, fewer children are being newly infected with HIV than ever before. This is according to data released earlier this week by the Joint United Nations Programme on HIV/AIDS. Yet, we are not on track to reach the Global Plan's goal of a 90 percent reduction by the end of 2015.
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Globally, fewer children are being newly infected with HIV than ever before. This is according to data released earlier this week by the Joint United Nations Programme on HIV/AIDS (UNAIDS) in its new report How AIDS changed everything--MDG 6: 15 years, 15 lessons of hope from the AIDS response.

UNAIDS estimates that, in 2014, 174,000 children were newly infected with HIV across the 21 priority countries of the Global Plan towards the Elimination of New HIV Infections among Children and Keeping their Mothers Alive (Global Plan). This represents a 48 percent reduction in new infections among children since 2009 (the baseline year for the Global Plan) across countries that still account for nearly 80 percent of all new HIV infections among children worldwide. This is an impressive achievement, which should be widely celebrated. Yet, as a global community, we are not on track to reach the Global Plan's goal of a 90 percent reduction by the end of 2015.

In 2011, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and UNAIDS joined forces to launch the Global Plan in order to accelerate efforts toward eliminating mother-to-child transmission of HIV and expanding access to antiretroviral treatment (ART) for mothers and children. In many countries, the Global Plan has helped to do just that. Based on the latest data, six priority countries -- Ethiopia, Mozambique, Namibia, South Africa, Swaziland, and Uganda -- have achieved a greater than 60 percent reduction in new HIV infections among children since 2009. Elsewhere, there have been gains, but progress has been much slower. Seven priority countries -- Angola, Cameroon, Chad, Cote d'Ivoire, the Democratic Republic of Congo, Kenya, and Nigeria -- reduced new infections among children by 30 percent or less since 2009.

PEPFAR is proud of its contributions to reducing new HIV infections among children, expanding access to ART for adults and children, and preventing new infections among adolescent girls and young women. In Fiscal Year 2014, PEPFAR provided HIV testing for more than 14.2 million pregnant women. For the 749,313 of these women who tested positive for HIV, PEPFAR provided antiretroviral medications to prevent mother-to-child transmission (PMTCT) of HIV. Due to PEPFAR support, 95 percent of these babies were born HIV-free, including 240,000 that would otherwise have been infected.

To achieve epidemic control, and ultimately an AIDS-free generation, PEPFAR is using data to target our resources to the highest burden geographic areas and populations, bringing more HIV/AIDS services, including for PMTCT, to where they are needed most. We have moved rapidly to phase out single drug prophylaxis regimens, so that mothers living with HIV/AIDS receive more efficacious regimens, both for their own health and that of their children. We also are linking pregnant and breastfeeding women diagnosed with HIV to PEPFAR-supported orphans and vulnerable children programs to enhance support for adherence to ART, follow up testing of infants, and early child development.

The new data also show that despite some improvement coverage of ART among children remains woefully low. Across the 21 Global Plan priority countries, only 31 percent of children under 15 years of age who are living with HIV/AIDS have access to ART. This is why, last August, PEPFAR and the Children's Investment Fund Foundation partnered to launch the $200 million Accelerating Children's Treatment (ACT) initiative, which aims to reach an additional 300,000 children with ART by the end of 2016.

Eliminating new HIV infections among children requires prevention of new HIV infections in adolescent girls and young women. That is why, on World AIDS Day 2014, PEPFAR, the Bill and Melinda Gates Foundation, and the Nike Foundation, announced DREAMS -- an innovative $210 million partnership to give girls an opportunity to live Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe lives.

Since the Global Plan's launch, a number of countries have made remarkable progress in preventing new HIV infections among children, and saving the lives of mothers and children. Yet, in many countries, we are still far from the finish line. To reach the day when no child acquires HIV, when every adolescent girl and young woman can reach adulthood HIV-free, and when all children living with HIV/AIDS have access to lifesaving ART - we must follow the data, and use it to focus, refine, and accelerate our efforts. We can get there, but it will take all of us, pulling together, to make it happen.

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