Concrete Steps to Scale Up HIV Diagnosis and Treatment for Children and Adolescents

December 1, 2017

On November 17, 2017, leaders of major pharmaceutical and medical technology companies, multilateral organizations, donors, governments, organizations providing or supporting services for children living with HIV, and other key stakeholders participated in a High-Level Discussion on Scaling Up Early Diagnosis and Treatment of Children and Adolescents.

The meeting was convened by His Eminence Peter Kodwo Appiah Cardinal Turkson, Prefect of the Dicastery for the Promotion of Integral Human Development, in collaboration with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Joint United Nations Programme on HIV/AIDS (UNAIDS), Caritas Internationalis, the World Council of Churches-Ecumenical Advocacy Alliance, the World Health Organization, and the Elizabeth Glaser Pediatric AIDS Foundation.

Participants gathered to discuss ways to expedite the research, development, approval, introduction, and uptake of optimal drugs and formulations for infants, children, and adolescents. While there has been great progress in developing better antiretroviral drugs for adults living with HIV, the same cannot be said for pediatric treatment.

As Cardinal Turkson observed, “Without quick, effective, and cooperative action, our targets will not be fulfilled and, much more tragically, the HIV-related illnesses will continue to claim the lives of too many young children.”

Building on meetings held in 2016 and 2017, The High-Level Dialogue provided an opportunity for Stakeholders to put forward a set of concrete actions to better support the research, development, and introduction spectrum. As a result, we are pleased to release, in partnership, a new Action Plan for Scaling Up Early Diagnosis and Treatment of Children and Adolescents, which has been endorsed by stakeholders from all sectors and built on commitments within the Global Accelerator for Pediatric Formulations (GAP-f) and the Start Free Stay Free AIDS Free framework. In this plan, the Participants agreed to focus, accelerate, and collaborate on the development, registration, introduction, and roll-out of the most optimal pediatric formulations and diagnostics. For individual commitments, please see the Annex to the Action Plan.

PEPFAR is fully supportive of the new Action Plan and will be taking positive steps in 2018 toward the goal of ending HIV among children by 2020, including additional support and funding of research to inform development, approval, and use of pediatric formulations, as well as supporting actions required for quick introduction and scale-up of new, optimal pediatric formulations.

A key reason for our global success is the role of the Food and Drug Administration and its willingness to look at what is needed and create a workable pathway for earlier access to safe and effective drugs. Recently, it has noted a new innovative approach that brings a parallel drug development process for the most vulnerable populations we serve: infants and children.

Deborah L. Birx, M.D., U.S. Global AIDS Coordinator and Special Representative for Health Diplomacy, closed the meeting by saying, “We understand the challenges we must face together to reach our goals for pediatric treatment by 2020. The urgency to reach children in need of HIV testing before they get sick is critical to getting them tested and ensuring they have safe, effective, sustainable, and affordable treatment.”

Among the 2.1 million children living with HIV, only 43 percent are receiving antiretroviral therapy (ART), compared with 54 percent among adults. While there has been considerable progress in the scale-up of ART globally, the year-on-year increase is slowing among children. PEPFAR has prioritized reaching children and adolescents, but we know that more work must be done.