It is Time to Re-engage in the Fight for an AIDS-free Generation

Later this week, scientific experts, policy makers, and activists from around the world will convene in Montreal for the 2022 International AIDS Conference. The conversations and presentations at IAS will speak to the urgency of this moment in the fight against HIV and AIDS, particularly as the global health community continues to grapple with the trauma incurred by the COVID-19 pandemic. But this meeting is more than a chance to reflect on the considerable disruptions that COVID-19 has had on the work to end HIV and AIDS. Rather, it is a prime opportunity for leaders and innovators to collectively, as this year’s theme suggests, re-engage and follow the science in order to make the groundbreaking and necessary strides to achieve an AIDS-free generation.   

There’s no question that COVID-19 has had a significant impact on the global community’s response to HIV in children. Recent data from the CDC on pediatric HIV case identification in PEPFAR-supported countries showed that in the first three months of the COVID-19 pandemic alone, HIV testing and case identification among children and adolescents aged 1-14 years in 22 PEPFAR-supported countries fell by over 40% and 29% respectively. Additionally, Global Fund data showed that in 2020 HIV testing dropped by 22% in countries in which the organization serves while a little over half (54%) of children in these countries are accessing necessary lifesaving treatment.  

 As troublesome as these figures are, the setbacks facing kids in the fight for an AIDS-free generation should not solely to be attributed to the COVID-19 pandemic, particularly as progress to end HIV and AIDS stalled prior to the emergence of COVID. Data from the 2020 Start Free, Stay Free, AIDS Free initiative revealed that nearly 150,000 children were newly infected with HIV – a figure nearly four times higher than the targeted goal of 40,000. What's more, children are nearly 40% less likely than adults to be on life-saving treatment and account for a disproportionate number of deaths from AIDS-related causes. The report also indicated that as of 2020, children represent five percent of people living with HIV but represented 15% of all AIDS-related deaths globally with almost 90% of children living with HIV located in sub-Saharan Africa. We can, and we must, do better. 

 In order to do better, we need to be better; and to be better, we need to innovate. As intimidating as it might seem, innovation should not frighten the global health community, but rather it should excite and inspire it. One only needs to look at bold programs like the President’s Emergency Plan for AIDS Response (PEPFAR). At its inception nearly 20 years ago when the global AIDS pandemic was at its worst, PEPFAR put forth a game-changing model for responding to the global HIV epidemic at an unprecedented scale. By following and implementing two decades of scientific advances, it has saved nearly 21 million lives.  

 Building off of PEPFAR’s success, the global community must find ways to innovate by establishing new investments and leveraging existing platforms like PEPFAR to sustain our efforts on existing pandemics even as newer pandemics emerge. Recently, Dr. John Nkengasong, head of PEPFAR and the U.S. Global AIDS Coordinator, remarked that the HIV and COVID-19 pandemics have demonstrated the need for the global health community to respectfully collaborate and “reimagine global architecture.” Simply relying on the same practices enacted by the same structures established decades ago is not a reliable way to respond to the complex, rapidly-evolving challenges posed by pandemics such as COVID-19, HIV and AIDS. “We have to be very deliberate in the way that we disrupt the systems that are currently in play positively because the world has changed a lot since the current systems were put in place,” he stated.  

 A part of deliberately disrupting these outdated systems is reimagining the world’s response to the AIDS pandemic in a way that explicitly prioritizes children. By speeding up the adoption and formulation of pediatric antiretroviral drugs as well as improving the manner in which children are included in data collection, the global health community can meaningfully improve the lives of kids most at risk of or living with HIV. While at IAS, EGPAF staff and experts will present a number of sessions and workshops, all which you can view here, to conference attendees. These sessions will offer innovative solutions that are tailored to the unique needs facing children in the fight against HIV and AIDS, and will encourage the global community to follow the science, innovate, and capitalize on this pivotal moment as a chance to stand up for children everywhere and win the fight for an AIDS-free generation.