Africa’s HIV-Aids alliance (mostly) achieved solid results, but too many children still infected

About 57% of children living with HIV receive lifesaving treatment. (Towfiqu Barbhuiya/EyeEm/Getty Images)

• Nine African countries, which form part of the Global Alliance, are on course to eradicate mother-to-child transmission of HIV.
• However, the majority of HIV cases among children globally are in sub-Saharan Africa.
• Just 57% of children living with HIV receive lifesaving treatment, compared to 77% of adults.

Only 52% of children living with HIV were on life-saving treatment in 2023, with sub-Saharan Africa doing particularly poorly.

This is why 12 African countries came together to form the Global Alliance for Ending Aids in Children by 2030.

Two years later, the majority of those countries have reported considerable success in providing healthcare to pregnant and breastfeeding women infected with HIV.

In a statement, the alliance said Uganda’s coverage was now nearing 100%, Tanzania had achieved 98%, South Africa 97%, and Mozambique 90%.

Zambia stands at 90%, Angola and Kenya at 89%, Zimbabwe boasts 88%, and Cote d’Ivoire at 84%.

This suggests mother-to-child transmission has been greatly reduced, which will impact future numbers, including death rates. 

Within the alliance, only Cameroon, the DRC and Nigeria did not register notable results.

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UNAIDS executive director Winnie Byanyima said it was possible to achieve results because the tools were available.

“With the medicines and science available today, we can ensure that all babies are born – and remain – HIV free, and that all children who are living with HIV get on and stay on treatment.

“Services for treatment and prevention must be ramped up immediately to ensure they reach all children everywhere. We cannot rest on our laurels. 

“The death of any child from Aids-related causes is not only a tragedy but also an outrage. Where I come from, all children are our children. The world can and must keep its promise to end Aids in children by 2030,” Byanyima said.

Gaps remain

While the 12 members of the alliance have what can be done, Tedros Adhanom Ghebreyesus, the director-general of the World Health Organisation (WHO), said there were still gaps.

“We are still far from closing the paediatric treatment gap. We need to further strengthen the collaboration and reach of the Global Alliance, and we must do this work with focus, purpose and in solidarity with all affected mothers, children, and adolescents,” he added in a statement.

According to UNAIDS, about 120 000 children under 14 contracted HIV last year.

Approximately 77 000 of those infections were in countries that form the alliance. 

There were 76 000 Aids-related deaths of which 49 000 were in alliance countries.

Mother-to-child transmission remains high in central and west Africa. Alliance members Nigeria and DRC have vertical transmission rates above 20%.

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For UNICEF associate director HIV/Aids Anurita Bains, the main worry was that adults received more attention than children.

“Just 57% of children living with HIV receive lifesaving treatment, compared to 77% of adults,” she said.

Bains suggested partners should work with governments to serve children and adolescents with activities such as early testing and treatment.

“To close the treatment gap, we must support governments to scale up innovative testing approaches and ensure children and adolescents living with HIV receive the treatment and support they need,” she said.

Young girls, between the ages of 15 and 24, are the most affected, with 130 000 of the 210 000 new infections in that gender and age group worldwide last year coming from alliance countries.

This figure is four times higher than the 50 000-estimate projected for 2025.

UNAIDS said this failure was because “gender inequalities and human rights violations are increasing women’s vulnerability to HIV and diminishing their ability to access essential services”.

The News24 Africa Desk is supported by the Hanns Seidel Foundation. The stories produced through the Africa Desk and the opinions and statements that may be contained herein do not reflect those of the Hanns Seidel Foundation.