MONTREAL, CANADA 29 July 2022—The Joint United Nations Programme on HIV/AIDS (UNAIDS) welcomes the latest data released by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which demonstrate the life-saving impact of PEPFAR funding and programmes on countries and communities. UNAIDS also applauds the continued, strong bipartisan leadership of the United States in the global response to HIV.

“PEPFAR’s latest impressive results show the outstanding impact and unique contributions of the United States to meeting the 2025 global HIV targets,” said Winnie Byanyima, UNAIDS Executive Director. "At a moment when some other bilateral donors retreated from their global commitments, the United States Administration and Congress continued to give strong, and critical support to PEPFAR, enabling countries to transition from epidemic control towards ending their AIDS epidemics,” said Ms Byanyima. “Together we are rallying other donors to follow the United States’s example.”

PEPFAR announced the new data on the opening day of the 24^th International AIDS Conference, presenting the life-saving impact of PEPFAR investments and programmatic support to partner countries.

Ambassador John Nkengasong, United States Global AIDS Coordinator and Special Representative for Health Diplomacy said, “Comprehensive HIV prevention and treatment programmes have always been a priority for PEPFAR. Through the reduction of incidence and prevalence of HIV among adolescent girls and young women, women of childbearing age, and adult men, an additional 3.5 million babies were born HIV free between 2004 to 2021 and a total of 5.5 million babies have been born HIV-free as a result of PEPFAR and its partners.”

PEPFAR’s statement can be read at https://www.state.gov/pepfar-shows-impact-with-5-5-million-babies-born-hiv-free-due-to-comprehensive-program-efforts/

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 06 May 2022—UNAIDS warmly congratulates John Nkengasong on confirmation by the U.S. Senate as Ambassador-at-Large and Coordinator of United States Government Activities to Combat HIV/AIDS Globally. As the new U.S. Global AIDS Coordinator, Dr Nkengasong will lead the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR).

“This is great news for the world. John Nkengasong is an inspired choice to lead PEPFAR,” said Winnie Byanyima, Executive Director of UNAIDS. “He is one of the world’s leading experts on HIV and pandemic preparedness and has practical experience on how to advance efforts to end AIDS amidst the COVID pandemic. We need the kind of bold thinking and commitment that he has brought throughout his career. It will be a true honour to work with him in his new role, supporting continued United States leadership on HIV, and strengthening the life-saving partnership between the UNAIDS Joint Programme and PEPFAR.”

An HIV virologist with more than three decades of experience in the global HIV response, Dr Nkengasong’s work on COVID-19 in his most recent highly acclaimed role as the founding director of the Africa Centres for Disease Control and Prevention has been internationally recognized.

PEPFAR is a critical partner of UNAIDS, with an unprecedented proven track record of global life-saving work. In over 80 countries, PEPFAR and UNAIDS work hand-in-hand providing support to governments and communities to implement the Global AIDS Strategy and accelerate ending AIDS. Together they ensure that efforts are focused on the people and areas most affected by HIV, including supporting children, women and girls, and key populations.

Since its inception in 2003, the US Government, with bipartisan support, has invested over US$100 billion through PEPFAR – the largest commitment by any nation to address a single disease. The United States’ investments and efforts have saved more than 21 million lives, prevented millions of HIV infections, and accelerated progress toward ending AIDS in over 50 countries.

The world is currently confronted with dual global pandemics. As Dr Nkengasong has noted, “We have seen how COVID-19 has affected some progress in our HIV efforts with devastating results, but we have also witnessed how the health systems and institutions built and strengthened by PEPFAR’s investments have been central to the COVID-19 response.” Through bold global action, the end of AIDS is possible, and actions to accelerate ending AIDS will strengthen the world’s efforts to beat all pandemics.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 28 September 2021—UNAIDS warmly welcomes the intent of the President of the United States of America, Joe Biden, to nominate John Nkengasong as Ambassador-at-Large and Coordinator of United States Government Activities to Combat HIV/AIDS Globally at the Department of State.

One of the world’s leading pandemic experts, Mr Nkengasong is an HIV virologist with decades of experience in the global AIDS response and is the current Director of the Africa Centres for Disease Control and Prevention. He is an inspired choice to lead the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the largest response in history by any nation to a single disease.

“John Nkengasong’s vast experience in combatting HIV, combined with his position as Africa’s leading disease expert fighting Ebola, COVID-19 and more, position him extremely well to guide the United States’ global contribution towards ending the AIDS pandemic,” said Winnie Byanyima, Executive Director of UNAIDS. “Today, the HIV and COVID-19 pandemics are colliding in communities throughout the world, and the threat of a resurgent AIDS pandemic is very real. We need the kind of bold thinking and commitment he has brought throughout his career.”

Previously, Mr Nkengasong was Acting Deputy Director, Center for Global Health, United States Centers for Disease Control and Prevention (CDC), and prior to that the Chief of the International Laboratory Branch, Division of Global HIV/AIDS and Tuberculosis, at the CDC. He also served as the Associate Director for Laboratory Science, Division of Global AIDS/HIV and Tuberculosis, Center for Global Health, CDC, and Co-Chair of PEPFAR’s Laboratory Technical Working Group. Mr Nkengasong has served as a member of the UNAIDS Advisory Group since 2019 and as the World Health Organization Director-General’s Special Envoy on COVID-19 Preparedness and Response since 2020.

Marking its 25th anniversary this year, UNAIDS has long partnered with PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria to advance progress towards ending AIDS as a public health threat by 2030 as part of the United Nations Sustainable Development Goals.

UNAIDS is very grateful to the Acting United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy, Angeli Achrekar, and her team, who have steered PEPFAR through a year of transition between administrations, and multiple pandemics, with urgency and expertise. Ms Achrekar will continue to lead PEPFAR through Mr Nkengasong’s Senate confirmation process.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) came together this week to co-host an event on the powerful partnership between the three organizations, countries and communities. The event, held on the sidelines of the 76th session of the United Nations General Assembly, highlighted the millions of lives saved through the partnership but warned that COVID-19 has hit hard and risks derailing efforts to end AIDS by 2030.

“We are in one of the most challenging moments in the history of HIV and global health,” said Winnie Byanyima, the Executive Director of UNAIDS. “We must act urgently. Our partnerships are strong and flexible and we must use what we have learned together to prevent a resurgent AIDS pandemic, to end inequalities and to tackle COVID-19.”

COVID-19 has had a hugely damaging impact on HIV services over the past 18 months. Peter Sands, the Executive Director of the Global Fund, said that the number of mothers receiving prevention of mother-to-child transmission of HIV services dropped by 4.5%, the number of people reached with HIV prevention programmes declined by 11%, HIV testing declined by 22% and voluntary medical male circumcision for HIV prevention dropped by 27%. “We were off track against our targets before COVID-19 hit and COVID-19 has knocked us further off track,” he said. “It’s going to be incredibly difficult to get fully back on track on HIV until we have got on top of COVID-19.” 

Widening inequalities due to COVID-19 were highlighted by the First Lady of Namibia, Monica Geingos, who joined Ms Byanyima in a live discussion from New York, United States of America. “After lockdown we are seeing a doubling of adolescent pregnancy rates, and we are assuming that new HIV infections among 15–24-year-olds will also increase,” she said. “When you remove children from a school environment, when you remove sex education you compromise education outcomes.” UNAIDS data show that if girls complete secondary education, it can reduce their risk of HIV infection by up to half in some countries.

Felix-Antoine Tshisekedi Tshilombo, the President of the Democratic Republic of the Congo and Chair of the African Union, joined the event with a powerful video message, saying, “We have been fighting HIV for 40 years and our successes and failures have taught us that we cannot conquer a pandemic without ending inequalities, promoting people-centred approaches while respecting human rights.”

The need for strong and continued partnerships to tackle both HIV and COVID-19 was strongly emphasized. Angeli Achrekar, the Acting United States Global AIDS Coordinator, who joined the event live in New York, said, “Nothing is possible without partnership. The partnership we have with PEPFAR, the Global Fund and UNAIDS is absolutely essential because we work hand in hand with countries and communities, the private sector and multilateral organizations to make things happen.”

The speakers urged bold political leadership, global solidarity and strategic partnerships that engage the people most affected by HIV. “What we need from governments is that they know that without us they cannot reach communities and achieve the ambitious goals,” said Sbongile Nkosi, the Co-Executive Director of the Global Network of People Living with HIV, who joined live from South Africa. “Governments must understand that we are the best allies in the response. We know the struggle, we know the solutions and we are committed to ending AIDS.”

The event was held at a landmark moment, 40 years since the first AIDS cases were reported and at the 25th anniversary of UNAIDS and the 20th anniversary of the Global Fund. “Forty years ago, a new virus emerged and sparked the HIV/AIDS pandemic,” said Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization. “Life-saving medicines were developed but the world’s poorest had no access to them and addressing this dire crisis of inequity took more than a decade. The multisectoral efforts often led by communities of people living with or affected by HIV were supported by unprecedented levels of international assistance from UNAIDS, the Global Fund and PEPFAR. Since then, millions of lives have been saved.”

There have been major successes in stopping new HIV infections among children and reducing AIDS-related deaths, but despite a 59% decline in AIDS-related deaths among children between 2010 and 2020, Omar Abdi, the Deputy Executive Director of the United Nations Children’s Fund, stressed that much more needs to be done. Just 54% of children living with HIV were accessing HIV treatment in 2020, compared to 74% of adults. “Ending AIDS in children needs our collective action to link the 1.7 million children living with HIV globally to HIV treatment to keep them healthy and alive. That’s why we are proposing a global framework to drive commitment and catalyse global action to end paediatric AIDS,” he said.

Usha Rao-Monari, the Associate Administrator of the United Nations Development Programme, highlighted the inequalities preventing key populations from accessing HIV services. She said that HIV services for key populations are “uneven or entirely absent” and underscored that key populations and their sexual partners account for 65% of new HIV infections worldwide, and for 93% of infections outside of sub-Saharan Africa. “Our work is absolutely not done,” she said. “Gender and other intersecting inequalities as well as punitive and discriminatory laws make people more vulnerable to HIV and hinder access to services. We need to address the inequalities that for decades have fuelled the spread of HIV.”

The hybrid event was a mixture of in-person discussions from the live venue in New York, video messages and live video link-ups from around the world. It was moderated from Nairobi, Kenya, by award-winning journalist Victoria Rubadiri, with live moderation of in-person discussions in New York by Regan Hofmann, Director, a.i., of the UNAIDS Liaison Office in Washington, DC, United States. 

Nigeria has demonstrated that putting people at the centre of the AIDS response works in advancing HIV service delivery. The 2018 Nigeria HIV/AIDS Indicator and Impact Survey identified 10 states with HIV prevalence above 2%, nine of which had a significant unmet need for HIV treatment and were at risk of being left behind if no action was taken. These states were prioritized by the national AIDS response for concerted action with the help of the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).

In 2020, while many countries experienced HIV service disruptions, the PEPFAR-supported HIV programme in Nigeria experienced significant growth and exceeded some targets.  

“The achievements of Nigeria with PEPFAR and the Global Fund in 2020 have significantly moved the needle towards treatment saturation and advanced the hope of epidemic control and the end of AIDS in these states and the entire country,” said Osagie Ehanire, the Minister of Health of Nigeria.

PEPFAR’s leadership and implementing partners took quick action and fast-tracked their community engagement plans, utilizing existing community network machinery to ensure there were no disruptions in the delivery of HIV services.

“Thanks to PEPFAR and its implementing partners, Nigeria was able to ensure not just continuity of HIV services, but was able to expand the reach, despite the country being locked down due to COVID-19,” said Gambo Aliyu, Director-General of the National AIDS Coordination Agency. “A record 279 000 people living with HIV additionally were put on treatment during this period.”

PEPFAR, together with its implementing partners, developed a people-centred package of services that was informed by data, best practices and community intelligence. The package recognized that one size does not fit all and catered for the unique needs of the various populations served.

Existing community networks, including key population networks and social groups, were consulted to determine the best way to make sure that the services that people need were available to them in their homes, at social gatherings or through support groups—thus minimizing contact with facilities.

Community antiretroviral therapy teams (CART teams) went to hard-to-reach areas around the country as well as to areas effected by COVID-19 lockdowns. Programmes such as a minimum three-month provision of antiretroviral therapy and viral load services were provided at treatment pick-up areas, which not only helped community-led providers to ensure that people stayed on treatment but saw a record number of people living with HIV start on treatment. By the end of 2020, the majority of people on treatment were included in the multimonth dispensing programme, which had a large impact on HIV treatment retention and adherence.

Viral load samples were collected in the communities, sent to laboratories for analysis and the results were then sent to health-care facilities, from where people were notified—this had a positive impact on viral load coverage. Index testing was expanded through community networks, ensuring continuity and safety as well as improvements in testing and case finding.

Results were seen across the entire 90–90–90 cascade as follows:

• An increase in people on HIV treatment of more than 279 000 people living with HIV in 2020, with more than 131 000 people being initiated and retained in care during the fourth quarter alone. PEPFAR Nigeria showed excellent success, accelerating efforts to identify people living with HIV and link them to care, with quarter-on-quarter growth. The growth in people on HIV treatment saw an additional seven states moving towards treatment saturation since the initiation of the “surge” programme approach, where intervention efforts are dramatically scaled up. Key populations represented approximately 25% of this overall growth, as the number of people on treatment among most key populations tripled. Key populations also had a testing yield of more than 10%.
• Improvements in pre-exposure prophylaxis (PrEP) uptake, especially among key populations. The number of people newly initiated on PrEP rose from nearly 2000 in the third quarter of 2020 to nearly 23 000 in the fourth quarter.
• Scale-up of multimonth dispensing from 55% in the first quarter to 94% in the fourth quarter 2020 was a key factor in improved continuity of treatment.
• Improvement in viral load coverage (88%) and suppression (93%) by the third quarter, building on previous successes and maintaining those gains to approach the third 90 target in a little over six quarters.
• PEPFAR’s orphans and vulnerable children programme achieved and exceeded all targets set for the year, including more than a million orphans and vulnerable children served by PEPFAR Nigeria by the end of 2020. Additionally, 98% of those under the age of 18 years in the orphans and vulnerable children programme have a documented HIV status, and approximately 100% of those who tested HIV-positive started treatment.

These results could not have been achieved without the support of community-led organizations. “The Network of People Living with HIV/AIDS in Nigeria (NEPWHAN) wishes to thank PEPFAR for the continuous engagement of our members across the country in the provision of HIV services to people living with HIV,” said Ibrahim Abdulkadir, NEPWHAN National Coordinator. “This has increased retention in care and improved quality of life for people living with HIV, as well as viral suppression among people living with HIV on antiretroviral therapy.”

PEPFAR Nigeria has designed its approach so that it can be owned by the Nigerian people. The National Data Repository and the National Alignment Strategy are key building blocks of a long-term and sustainable public health and health services approach to ending the AIDS epidemic in the country.  

“I am profoundly impressed by the progress that PEPFAR Nigeria has made, in collaboration with the Government of Nigeria, partners and allies, to identify, enrol and sustain so many Nigerian people living with HIV on life-saving treatment,” said Bill Paul, the Deputy Coordinator for Program Quality, Office of the United States Global AIDS Coordinator. “Their success in sustaining the effort despite the impact of COVID-19 would not have been possible without a supportive policy environment both in the government and in the United States embassy.”  

Based on these accomplishments, Nigeria is well-positioned to accomplish the 95–95–95 targets well in advance of 2030.

At the end of 2020, progress on the 90–90–90 treatment targets was 73–89–78—that is, 73% of people living with HIV had been diagnosed, 89% of those diagnosed were accessing treatment and 78% of those accessing treatment were virally supressed.

The proposed new global AIDS strategy calls for putting people at the centre of the HIV response, empowering communities and closing the gap on inequalities. “Nigeria is poised to be the next HIV turnaround country, after South Africa. We have all the ingredients to make this happen and I commend PEPFAR for working with the government, communities and partners to show the world that this is the only way to end this pandemic, by working with the affected communities,” said Erasmus Morah, the UNAIDS Country Director for Nigeria.

The Global Fund to Fight AIDS, Tuberculosis and Malaria, the Government of Congo and health partners have announced two new grants worth more than US$ 64 million to strengthen prevention and treatment services to respond to HIV, tuberculosis and malaria and to build resilient and sustainable systems for health in Congo.

The two grants are a 97% increase from the previous allocation against the three diseases and will be spent from 2021 to 2023.

“UNAIDS looks forward to continuing to work closely with all partners to accelerate the elimination of vertical transmission of HIV and paediatric AIDS in Congo and to improve access to HIV/tuberculosis programmes, sexual and reproductive health, and legal services for young women and adolescent girls and all groups at higher risk of contracting HIV,” said Winnie Byanyima, Executive Director of UNAIDS.

The HIV grant will significantly increase the number of people living with HIV who know their HIV status and will expand access to life-saving antiretroviral therapy, particularly for pregnant women. In 2019 in Congo, only 51% of people living with HIV knew their HIV status and only 25% of people living with HIV were accessing antiretroviral therapy. Only 10% of pregnant women living with HIV in Congo were offered antiretroviral medicine to prevent the virus being passed to their babies.

The tuberculosis component of the grant aims to boost the national tuberculosis response, increase the notification of new tuberculosis cases and reach a 90% treatment success rate by 2023, in line with the World Health Organization’s End TB Strategy. The grant will also support the country’s efforts to improve treatment success for people with multidrug-resistant tuberculosis. The malaria grant will support the country’s goal to distribute 3.5 million mosquito nets by 2023 and expand access to quality malaria diagnostics and treatment tools.

“In the context of the country’s financial crisis, exacerbated by the COVID-19 pandemic, the grants allocated to Congo are a breath of fresh air. They provide renewed impetus to the government’s action in favour of populations affected by HIV, tuberculosis and malaria,” said the Prime Minister of Congo, Clément Mouamba.

The United Nations Development Programme will implement the HIV and tuberculosis grant, while Catholic Relief Services will implement the malaria grant.

Global partners that are committed to ending paediatric AIDS have come together to call on countries to rapidly scale up access to optimal, child-friendly HIV treatment for infants and children. The partners include the United Nations Children’s Fund, the World Health Organization (WHO), UNAIDS, the United States President’s Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Unitaid, the Elizabeth Glaser Pediatric AIDS Foundation, and the Clinton Health Access Initiative (CHAI).

Children living with HIV continue to be left behind by the global AIDS response. In 2019, only 53% (950 000) of the 1.8 million children living with HIV (aged 0–14 years) globally were diagnosed and on treatment, compared to 68% of adults. [1] The remaining 850 000 children living with HIV have not been diagnosed and are not receiving life-saving HIV treatment. Two thirds of the missing children are aged 5–14 years and do not routinely attend traditional health facilities. Engaging communities and the families of people living with HIV, tuberculosis and other related diseases and offering family services are needed in order to find and start on treatment those missing children.

An estimated 95 000 children died of AIDS-related illnesses in 2019, in part due to lack of early diagnosis of HIV among infants and children and immediate linkage to optimal HIV treatment regimens. Untreated, 50% of infants infected with HIV during or around the time of birth will die before the age of two years. [1]

The United States Food and Drug Administration recently gave tentative approval for the first generic formulation of dolutegravir (DTG) 10 mg dispersible tablets. [2] This approval was the result of an innovative partnership between Unitaid, CHAI and ViiV Healthcare, together with generic suppliers, which accelerated the timeline of development by several years. The approval was quickly followed by the announcement on World AIDS Day of a groundbreaking agreement negotiated by Unitaid and CHAI that reduces the cost of HIV treatment by 75% for children in low- and middle-income countries, where the DTG 10 mg dispersible tablets will be available at a cost of US$ 4.50 for a 90-count bottle. [3] 

This now means that WHO-recommended, preferred first-line DTG-based antiretroviral treatment is now available in more affordable and child-friendly generic formulations for young children and infants as young as four weeks of age and weighing more than 3 kg. [4]  Rapid transition to this treatment, in combination with improved HIV diagnosis for children and other supportive measures, will help to urgently reduce the 95 000 preventable AIDS-related deaths in children.

DTG-based HIV treatment leads to better outcomes for children. DTG is less likely to be affected by drug resistance and achieves viral load suppression sooner; child-friendly dispersible tablets improve adherence due to a lower pill burden and being easier to administer. These factors help children achieve and maintain viral load suppression, the gold standard for measuring the effectiveness of HIV treatment. DTG-based treatment is the standard of care for adults. Starting on this regimen from infancy reduces the need for changes in treatment as they mature through childhood, adolescence and adulthood. Fewer regimens and regimen changes simplifies management of health care, improves stock management and reduces wastage. 

WHO has recommended DTG-based HIV treatment for all infants and children since 2018 [4] and provided dosing recommendations for infants and children over four weeks of age and more than 3 kg in July 2020. [5]

Suppliers have indicated their ability to meet global scale-up ambitions. Accurate forecasts of demand are critical to inform production planning and delivery timelines. It is therefore critical that national programmes start including DTG 10 mg dispersible tablets in their new procurement plans, review stocks and orders for existing non-DTG treatment for children, share forecasts with HIV treatment procurement partners and suppliers and place orders as early as possible.

The partners are committed to support national governments as they develop rapid transition plans from existing suboptimal HIV treatment to DTG-based treatment for infants and children, including advocacy for political commitment, mobilizing international and domestic resources, new policies and guidelines, managing medicine supply, distribution and stock, training health-care workers and sensitizing and engaging affected communities to ensure demand and treatment literacy for children living with HIV and their caregivers in order to ensure rapid uptake of these new formulations.

Further guidance for national programmes and partners is available from WHO. [5] The CHAI HIV New Product Introduction Toolkit has dedicated resources to help countries transition to paediatric DTG. [6]

Quotes from partners

“National governments, partners on the ground and affected communities need to work together to find and treat the children and infants whose lives can be saved by these new medicines,” said Shannon Hader, UNAIDS Deputy Executive Director for Programme. “The new medicines are cheaper, more effective and more child-friendly than current treatments for infants and young children. We need to get them into clinics to save lives now.”

“The United States President’s Emergency Plan for AIDS Relief works tirelessly to ensure clients can access the best available HIV treatment, including advanced, paediatric regimens for children living with HIV,” said Deborah L. Birx, United States Global AIDS Coordinator and United States Special Representative for Global Health Diplomacy. “The accelerated introduction and expansion of paediatric DTG has the potential to save and improve the lives of thousands of children around the world. The United States President’s Emergency Plan for AIDS Relief will continue to collaborate with global and local partners to ensure the young children we serve can promptly access paediatric DTG.”

“Providing antiretroviral drugs to people living with HIV is at the core of our support to national HIV programmes,” said Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. “This new and affordable child-friendly HIV treatment is a tremendous step forward that will improve and save the lives of some of the most vulnerable in society—young children infected with HIV. We are committed to support countries to make a fast transition to these new drugs.”

“Children in low- and middle-income countries often wait years to access the same medications as adults, hindering their quality of life, or even resulting in preventable deaths. We are proud to have worked with partners on this groundbreaking agreement that will bring quality assured dispersible DTG to children at a record pace,” said Philippe Duneton, Unitaid Executive Director. “Ensuring access to this treatment will transform the lives of children living with HIV, helping them to remain on treatment and saving thousands of lives.”

“For the first time, children living with HIV in low- and middle-income countries will have access to the same first-line antiretroviral medication at the same time as those in high-income countries,” said Iain Barton, Chief Executive Officer of the Clinton Health Access Initiative. “The partnership should serve as a model to remove barriers that hinder development of paediatric formulations to deliver top-line medications quickly and affordably.”

“The persistent treatment gap between adults and children prevents us from achieving an AIDS-free generation,” said Chip Lyons, President and Chief Executive Officer of the Elizabeth Glaser Pediatric AIDS Foundation. “Children living with HIV around the world urgently require age-appropriate, effective and accessible formulations. Approval of dispersible DTG is a momentous step forward, but meaningless if this new formulation doesn’t quickly reach the babies and small children who desperately need it most. The Elizabeth Glaser Pediatric AIDS Foundation is committed to supporting accelerated roll-out, uptake and delivery of new, optimal paediatric antiretroviral medicines in partnership with global, regional and local leaders.”

“The persisting treatment gap between mothers and children is unacceptable with the new scientific breakthroughs that are within our reach to change the trajectory”, said Chewe Luo, Associate Director and Chief of HIV, United Nations Children’s Fund. “The United Nations Children’s Fund welcomes global commitments and progress made in developing better diagnostic approaches and optimal regimens for children to improve their outcomes.”

“This has the potential to be a true game-changer for children with HIV", said Meg Doherty, Director of Global HIV, Hepatitis and STI Programmes at WHO. “We must do all in our power to help countries get this new paediatric DTG 10 mg to all the children who need it."

[1] UNAIDS. Start Free Stay Free AIDS Free - 2020 report. 07 July 2020. https://www.unaids.org/en/resources/documents/2020/start-free-stay-free-aids-free-2020-progress-report

[2] https://www.accessdata.fda.gov/drugsatfda_docs/pepfar/214521PI.pdf

[3] UNITAID press release. Groundbreaking Agreement Reduces by 75% the Cost of HIV Treatment for Children in Low-and Middle-Income Countries. https://unitaid.org/news-blog/groundbreaking-agreement-reduces-by-75-the-cost-of-hiv-treatment-for-children-in-low-and-middle-income-countries/#en 

[4] World Health Organization. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV. Interim guidance. 1 December 2018, https://www.who.int/publications/i/item/WHO-CDS-HIV-18.51.

[5] World Health Organization. Considerations for introducing new antiretroviral drug formulations for children. Policy brief. 1 July 2020, https://www.who.int/publications/i/item/9789240007888.

[6] Clinton Health Access Initiative. HIV new product introduction toolkit. Pediatric 10 mg dispersible, scored resources, https://www.newhivdrugs.org/.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

As the Global Fund to fight AIDS, Tuberculosis and Malaria—one of the main donors for the HIV response in the last 20 years in Eastern Europe and Central Asia (EECA)—is moving away from funding the HIV response in EECA, the region is looking for ways to invest their available domestic resources in a much more cost-effective way.

“There are purely epidemiologic and economic arguments behind this transition,” said Dumitru Laticevschi, Regional Manager Eastern Europe and Central Asia Team, The Global Fund. “The economies here are considerably better for the same level of disease burden than the average in the world, that’s why it is expected that the region increasingly takes care of the epidemic by itself.”

The key challenge for the Global Fund, UNAIDS and other partners is to strengthen national responses and “to squeeze the problem to a size that is manageable for the governments to take over,” added Mr Laticevschi.

A series of HIV allocative efficiency studies conducted in 2014 in the region with support from the World Bank, UNAIDS Secretariat and some cosponsors, the Global Fund, USAID/PEPFAR and other partners, recommended countries to prioritize investment in the most cost-effective interventions to maximize health outcomes, including updating HIV testing and treatment protocols, reducing treatment costs, and optimizing service delivery. The studies were based on the Optima HIV mathematical modelling approach which has been applied in over 60 countries globally to help support HIV-related investment choices.

Recently, a new wave of the allocative studies was concluded in 11 countries of the region (Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Romania, Tajikistan, Ukraine, and Uzbekistan). Individual reports with a set of recommendations for each country, as well as a regional report with aggregated results from the eleven-country analysis are available here.

“We provided the technical support for these analyses,” said Sherrie Kelly, Team Lead HIV, TB, and Malaria Applications, Burnet Institute who supported the 2014 and 2019 studies in EECA. “We have the models in place and work with the national teams. The countries are the owners of the projects, data, and results. We are just the mathematical modelers.”

The modeling is informed by demographic, epidemiological, behavioural and other data, as well as expenditure estimates provided by national teams and available in the literature. The epidemic model is overlaid with a programmatic costing component and a resource optimization algorithm. Results are intensively discussed and validated by national teams and key stakeholders from respective countries. The UNAIDS Secretariat facilitated the entire process to ensure the capacity of national partners to facilitate optimized health spending was strengthened.

“We hope that the recommendations from the study will help our national partners to adjust National Strategic Plans and to focus on the most efficient, cost-saving interventions with maximum health outcomes and will not only save money, but will save people’s lives,” said Alexander Goliusov, UNAIDS Regional Director in EECA a.i..

The Global Fund to Fight AIDS, Tuberculosis and Malaria has raised US$ 14 billion for the three diseases for a three-year period (2020–2022)

GENEVA, 11 October 2019—UNAIDS is hugely encouraged by the firm commitment that donors have shown to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). At its Sixth Replenishment Conference, held in Lyon, France, on 9 and 10 October 2019, the Global Fund raised US$ 14.02 billion, the highest amount ever for the partnership, which is working to end the three diseases.

“I truly commend all countries and partners that have stepped up to the mark and committed to investing in the Global Fund to Fight AIDS, Tuberculosis and Malaria,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “These investments are a critical lifeline for millions of people around the world. Going forward, putting people at the centre will be critical for making the money work most effectively.”

UNAIDS congratulates the President of France, Emanuel Macron, for his personal engagement and his call on countries to increase their pledges to honour the proposed 15% increase above the last replenishment. Most donors matched or surpassed the 15% increase and many new donors attended and pledged for the first time.

UNAIDS will continue to work closely with the Global Fund providing strategic information, technical expertise and capacity-building to countries in sourcing and implementing Global Fund grants. UNAIDS advocates for a people-centred, human rights-based approach to ending AIDS and fully supports the active engagement of civil society and community-based organizations in reaching the most marginalized people and people being left behind. In 2018, there were 37.9 million people living with HIV, 15 million of whom are still in urgent need of access to life-saving antiretroviral therapy.

The pledges to the Global Fund will boost the response to HIV. UNAIDS will continue to advocate for increased investment to meet the full resource needs of the AIDS response to end AIDS by 2030 as part of the Sustainable Development Goals.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.