Getting to an AIDS Free Generation

Success in the fight to end AIDS in children has shown that effective partnership and persistent country leadership can produce transformational results – yet there is unfinished business.

Just a few years ago the idea of an AIDS free generation seemed purely aspirational-- or at the very least, highly unlikely. But today the East African Community partner states  have joined the international effort to end AIDS as a public health threat by 2030. If we are to meet the goal of ending AIDS in our region it is essential that countries, donors and key stakeholders prioritize children, adolescents and young women in our HIV approaches.  If we do not, we risk jeopardizing not only future progress but the hard fought progress that East Africa has seen to date on HIV and AIDS.

Progress on preventing and treating pediatric and maternal HIV has largely been driven by a unique partnership known as the Global Plan, led by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and UNAIDS with strong leadership from Ministries of Health, the World Health Organization (WHO), the United Nations Children Fund (UNICEF), the faith based community, and many other partners, including the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). The Global Plan targeted 21 countries in sub-Saharan Africa that have been most affected by HIV since 2009, working to reduce new HIV infections among children by 90% from the baseline year of 2009.

Four of the Global Plan’s 21 priority countries, Tanzania, Uganda, Kenya and Burundi are East African Community members. Since the plan began, new HIV infections in children have been reduced by 60% in the 21 targeted countries, resulting in 1.2 million children with HIV-positive mothers being born HIV-free. Together, the 21 Global Plan priority countries have reduced mother to child transmission rate from 22.4% in 2009 to a remarkable 8.9% in 2015. Such a relentless effort succeeded because of a sharp focus, strategic prioritization and adequate resources.

East African headway is particularly notable. Two of the three countries that made the greatest progress reducing new infections are the region, with Uganda reducing new pediatric HIV infections by 86% since 2009, followed by Burundi which reduced new HIV infections by 84%. Tanzania achieved a 69% reduction in new pediatric HIV infections in the same timeframe. Kenya achieved a 55% reduction and brought down mother-to-child transmission rates to 8.3%. 

Rwanda also has lessons to offer. In 2014 more than 95% of pregnant women living with HIV accessed antiretroviral medicines to prevent the transmission of HIV from mother to child. As a result, the country had fewer than 500 new infections among children in 2015, paving the way to achieving an AIDS-free generation.

Yet we still have unfinished business. The next five years are crucial and provide an opportunity to prioritize the needs of children, adolescents and young women, who are key to ending the epidemic. Of the 37 million people around the world living with the virus, nearly 1 in 8 live in the East African Community countries. One in 9 new HIV infections among children in 2015 occurred in these five countries.”

Without treatment, half of the children born with the HIV virus die before their second birthday. Today, AIDS is the leading cause of death for adolescents in sub-Saharan Africa.

The Global Plan ended in 2015. UNAIDS, PEPFAR and other partners have set a goal to end AIDS in children by 2020 under a new call to action:  Start Free, Stay Free, AIDS Free.  Launched in June 2016 at the United Nations, this effort builds on the successes of the past five years, while establishing a bold new framework, setting key targets to eliminate new infections among children, find and ensure access to treatment for all children living with HIV and prevent new HIV infections among adolescents and young women. 

Earlier this year UNAIDS Executive Director Michel Sidibe noted, “the world has an opportunity to end an epidemic that has defined public health for a generation, and to do so by 2030.” The achievements of the Global Plan have shown that unwavering focus, effective partnership and persistent country leadership, the East African and global health communities can achieve amazing results. If we continue on that path, prioritizing resources and committing to this framework, we could soon see something we’ve long searched for -- a new generation free from HIV/AIDS.

This article was originally published by the East African.