Every Child Counts: Our Commitments to Children, Adolescents, and Ending AIDS
Nearly 120,000 children acquired HIV in 2025.1 More than half a million children living with HIV are still not receiving life-saving treatment.2 Around 90,000 children and adolescents die from AIDS-related causes every year.3 That’s nearly 250 preventable deaths every single day. These are not the statistics of a problem being solved. As world leaders endorse the 2026 Political Declaration on HIV/AIDS this week, a document that will shape the global response for the next five years, the Coalition for Children Affected by AIDS (CCABA) is cautiously hopeful that the commitments made will generate the urgency needed to address the persistent gaps facing children and adolescents.
We welcome the commitments focused on the need of women, children, families, and youth, particularly around eliminating vertical transmission, paediatric treatment access and social protection. However, we know from two decades of advocacy that naming children in a preamble is not the same as building a response that reaches them. Explicit commitments matter. Operational detail matters. Accountability matters.
There are four areas where Member States must build on the Declaration through additional action to truly translate its commitments into meaningful results for children.
Ending paediatric AIDS means more than preventing transmission. Comprehensive follow-up care for mothers and HIV-exposed infants, early infant diagnosis, tracking of mother-infant pairs, repeat testing during breastfeeding, and integrated paediatric HIV services within maternal and child health platforms are the steps that find the children that health systems are still missing.
Children have distinct needs that deserve recognition. Child-friendly medicine formulations, mental health and psychosocial support, stigma reduction, and the meaningful participation of children and young people in decisions about their own care are not secondary concerns. They are the conditions under which treatment actually works.
Caregivers and family-centred approaches are essential to sustaining paediatric HIV outcomes, not ancillary or optional. Member States must prioritize support for caregivers, families and communities in their efforts to ensure that HIV services reach children. That is also why community-led organisations working specifically on children’s and adolescents’ needs should be more explicitly recognized within the 30-80-60 community leadership targets.
Integration must not mean invisibility. As health systems integrate, children risk becoming harder to see, not easier. Dedicated efforts to protect access to age-appropriate HIV services, diagnostics, and medicines as part of integrated service delivery is needed to ensure that integration improves outcomes for children rather than quietly diluting attention to their particular needs.
We must also recognise that children in humanitarian settings deserve specific protection. Conflicts, disasters, and crises disproportionately disrupt HIV treatment and care for children. They must be named in humanitarian response frameworks, not assumed to be covered by general references to women and girls.
The tools and the evidence exist. What is needed is the political will to make them work consistently for every child, in every setting. That is what the 2026 Political Declaration will hopefully provide and what the children it affects deserve.
- https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/strategic-information/hiv-data-and-statistics
- https://www.unicef.org/eca/press-releases/fast-facts-world-risks-reversing-hiv-progress-children-continue-face-treatment-gap
- https://data.unicef.org/topic/hivaids/global-regional-trends/