Deep Concern, Cause for Hope

To say that it is a dynamic time in global health is a remarkable understatement. Recent weeks have brought about rapid-fire fluctuations, each of which bears impact on children affected by HIV and AIDS. Our community has responded with a mixture of deep concern, but also cause for hope.

Already in a race against time to achieve our objectives, we now face new and significant threats to progress against HIV and AIDS. One such threat is the U.S. administration’s Executive Order to reinstate the “Global Gag Rule.” The current incarnation of this legislation, also known as the “Mexico City Rule,” includes all U.S. government global health spending. The Rule itself is not new, however, previous administrations applied it only to family planning streams. This latest iteration puts funding for non-family planning health work — including HIV prevention and maternal and child health, among other critical services — at very real risk.

The Trump Administration also put forth a budget proposal that includes dramatic funding cuts to both PEPFAR (with a proposed 18 percent budget reduction) and the Global Fund (with a proposed 17 percent, or $225 million). If approved, these reductions will have significant impact on HIV affected children and families throughout the world who are served by these programs.

But, as this community knows — perhaps better than any other — we are never without hope. In April, we received just that in the form of a progress report on the Accelerating Children’s HIV/AIDS Treatment (ACT) initiative, which highlights progress in providing children with access to life-saving drugs to fight HIV and AIDS. The first year of the initiative saw antiretroviral coverage for children under 15 rise in all nine of the initiative’s focus countries. As of September 2016, the end of the two-year program, ACT was supporting 561,610 children living with HIV with access to treatment throughout these same, high burden countries. The initiative also achieved important results in relation to HIV testing for children and identification of children living with HIV.

ACT’s results represent a critical contribution to the global frameworks and targets that guide responses to health, HIV, and pediatric care and treatment including the 90-90-90 treatment targets and the Start Free, Stay Free, AIDS Free framework. In addition, the lessons learned provide invaluable direction on success factors, gaps and potential roadblocks to progress.

It is, without question, a challenging time for our community. But we have a long history of meeting such challenges directly. When it comes to reaching all children affected by HIV and AIDS, backing down will never be an option.