Getting Back on the Path to Eliminating HIV in Children

Area of Science:

• Global Health
• Infectious Diseases
• Pediatric Medicine

Background:

• The COVID-19 pandemic initially tested global resilience in pediatric HIV control.
• Sudden disruptions in donor support for HIV assistance in 2025 pose existential threats to progress.
• Despite past successes, recent years show stalled progress in reducing pediatric HIV.
• Significant gaps remain in eliminating HIV among children globally.

Purpose of the Study:

• To analyze the impact of funding disruptions on pediatric HIV control.
• To reframe strategies for ending HIV as a threat to children.
• To identify key factors and barriers to overcoming remaining gaps in pediatric HIV elimination.
• To develop a framework for sustained progress in pediatric HIV care, less dependent on donor support.

Main Methods:

• Review of progress and challenges in global pediatric HIV control.
• Analysis of the impact of political and financial support disruptions.
• Identification of strategic pillars for success in pediatric HIV elimination.
• Framework development for a sustainable, evidence-based approach.

Main Results:

• Breathtaking reductions in pediatric HIV acquisitions, deaths, and orphanhood since the early 2000s.
• Progress has stalled in recent years, with persistent gaps in elimination efforts.
• Disruptions in U.S. government support necessitate strategic reframing and innovation.
• Key pillars for success include healthcare system integration, national leadership, public-private partnerships, and community engagement.

Conclusions:

• The current juncture demands a reevaluation of strategies to end pediatric HIV.
• Overcoming barriers requires robust integration into healthcare systems and strengthened national leadership.
• Innovation, private sector collaboration, and amplified community voices are crucial.
• A sustainable, person-centered, and community-informed path is essential to eliminate HIV as a threat to children.