African ministers of health called on the international community to make ending the paediatric AIDS epidemic a global political priority. Meeting in Abidjan, Côte d’Ivoire, on 10 May, dignitaries called for the Political Declaration on Ending AIDS, to be agreed upon at the upcoming United Nations General Assembly High-Level Meeting on Ending AIDS, to include targets to scale up prevention of mother-to-child transmission of HIV services and paediatric HIV testing and treatment.

Participants included 11 national ministers, as well as deputy ministers and senior HIV programme officials from across Africa, which is home to nearly 90% of all children living with HIV.

In 2014, 2.6 million children were living with HIV and 32% had access to antiretroviral therapy. Without treatment, half of all children living with HIV will die before they are two years old.

“Ending paediatric AIDS requires action at two levels,” said the First Lady of Côte d’Ivoire, Dominique Ouattara, UNAIDS Special Ambassador for the Elimination of Mother-to-Child Transmission and the Promotion of Paediatric Treatment for HIV. “On the one hand, we must prevent new HIV infections among children, and, on the other hand, we must provide treatment and care to all children who are living with HIV.”

Continued progress in preventing new HIV infections among children has been made by ensuring all pregnant women are tested for HIV and women living with HIV receive treatment. This has established a strong foundation for ending paediatric AIDS. But to make it a thing of the past, substantially better results are needed across the HIV treatment cascade for children.

UNAIDS projects that it is possible to end the epidemic of paediatric AIDS by 2020 if prevention and treatment targets are met by 2018. These include reaching 95% treatment coverage for both pregnant women and children living with HIV.

Recent trends point towards the feasibility of achieving these targets. Major gains have been made in providing antiretroviral medicines to pregnant women living with HIV to prevent transmission of HIV to their babies. From 2010 to 2014, new HIV infections among children dropped by 58%. In the same period, HIV treatment coverage among children living with HIV more than doubled.

However, more needs to be done to ensure that no child is left behind. “Today we have effective treatment regimens, yet how many children are still dying in the age of antiretroviral therapy?,” asked Jeanne Gapiya Niyonzima, president of the Burundi Association Nationale de Soutien aux Séropositifs et aux Malades du SIDA and mother of a child who died of AIDS-related causes at 18 months of age.

“This is a question of social justice, a question of equality,” said UNAIDS Executive Director Michel Sidibé. “We have the opportunity to have a Political Declaration on Ending AIDS from the United Nations General Assembly High-Level Meeting on Ending AIDS to help us set concrete objectives so that treatment becomes universal for everyone, wherever they find themselves.”

The African ministers attending the Abidjan meeting called for the Political Declaration on Ending AIDS to include clear targets to scale up prevention and treatment services in order to end paediatric AIDS. To achieve these targets, the ministers endorsed the immediate front-loading of resources for paediatric HIV treatment and the elimination of mother-to-child transmission of HIV.

Scientific developments have the potential to dramatically improve treatment outcomes for children. Ministers noted the importance of fully leveraging and scaling up innovative tools, including point-of-care technologies for early infant diagnosis, paediatric treatment regimens recommended by the World Health Organization and family-centred service delivery approaches that improve retention in care and treatment adherence.

Ministers called for UNAIDS to coordinate initiatives on paediatric HIV treatment across all sectors. “We need to strengthen cooperation among stakeholders to get better results for children,” said Juliet Kavetuna, Deputy Minister of Health and Social Services of Namibia. “If we work in silos, we will never achieve our goal.”

The meeting generated considerable optimism regarding the potential to meet the 2018 targets for children. “We know what we have to do,” said David Parirenyatwa, Zimbabwe’s Minister of Health and Child Care. “The key is to do it in a systematic way and ensure that it is well-funded.”

Uganda’s Minister of State for Primary Health Care, Sarah Opendi, said, “Working together, we can end the AIDS epidemic among children, and also among adults.”

Prior to the closing remarks by the First Lady of Côte d’Ivoire, Mr Sidibé was presented with the Grand Officier de l'Ordre National de la République de Côte d'Ivoire, in recognition of his global leadership on behalf of children affected by HIV. In accepting the award, Mr Sidibé encouraged all participants to work towards the goal of ending paediatric AIDS.

Leading donors, programme implementers and civil society involved in paediatric HIV treatment, as well as private industry, also attended the ministerial meeting. The event was convened by UNAIDS, the Government of Côte d’Ivoire, ELMA Philanthropies, Funders Concerned About AIDS, the Children’s Investment Fund Foundation, Johnson & Johnson and Luxembourg. More than 150 people from 34 countries participated.