Speak Out for Better Resourcing for Children and Adolescents Affected by HIV

Corinna Csaky and Dr Stuart Kean on behalf of The Coalition for Children Affected by AIDS
Let’s use the 54th UNAIDS Programme Coordinating Board Meeting in June 2024 as an opportunity for us to champion children and adolescents. The Coalition has created these advocacy messages to accompany the thematic segment on sustaining the gains of the HIV response to 2030 and beyond.  We are also delighted that Coalition Young Mother Ambassador, Miriam Hasasha, has made this video promoting the role of young people and caregivers in improving resourcing.
We urge all champions for children and adolescents everywhere to promote them to the Member States, co-sponsoring UN agencies and NGO representatives on the PCB, as well as amongst your own networks.  We hope this will be of use to you and to children and adolescents everywhere. Let’s speak with one strong voice!

 MESSAGES

  1. We cannot end AIDS without investing in children and adolescents.  They are amongst those left furthest behind. And their ability to start free and stay free of HIV  is critical for ending the AIDS epidemic.  The number of new HIV infections amongst children is more than eight times the global target. And many millions of children and adolescents—both HIV-positive and -negative—are grappling with the impacts of the disease. Investing in services now will reduce the total funding required in the long-term as it will end AIDS in children by 2030.
  2. A new report from the Coalition for Children Affected by AIDS reveals, for the first time, how much is spent on children and adolescents affected by HIV around the world, on what, and where.  This is a vital piece of the puzzle and enables us to see where the funding gaps are to end AIDS in children.  This comes at an important time when many countries and donors have signed up to the Global Alliance to End AIDS in Children by 2030.
  3. There is a funding gap globally of around $1billion for children and adolescents under 18. Around $1.8bn is spent and$2.8 billion is required to achieve Global AIDS targets.  Of this, $160 million more is needed for biomedical support.  And a further $840 million is required for building strong health systems and tackling wider social and economic barriers.  A large proportion of this gap (roughly $410 million) is spending required for children and adolescents from key populations.  Their needs far outweigh the current level of investment.  
  4. The total spend on children and adolescents represents around 12% of all HIV/AIDS expenditures worldwide.  
  5. Just under half of the funding is from domestic national budgets. PEPFAR provides 36% and around 10% is from the Global Fund. The remaining circa 10% comes from other kinds of bilateral, multilateral and private donors and NGOs. 
  6. PMTCT and social protection, especially for OVCs, are the largest areas of spending. Pediatric ART is around 20%.  Spending on children associated with key populations is only around 7%.
  7. More than half of all expenditure is in 5 countries: Kenya, South Africa, Mexico, Mozambique and Uganda.  And spending in Low Income Countries  is far less than in High Income Countries.
  8. It will soon be possible to see the funding gaps for children at the country level. A forthcoming report will set out the funding gaps for children and adolescents in the priority countries of the Global Alliance to End AIDS in Children.  The Coalition for Children Affected by AIDS welcomes collaboration in this initiative.
  9. The 55th UNAIDS PCB Meeting, and its thematic focus on children is an ideal opportunity to examine and address in more detail the funding gaps for children.

RECOMMENDATIONS

  1. Donors and governments must urgently commit to fill the funding gaps. Including for support with finding the missing children living with HIV, testing and providing access to treatment, support for the children of key populations, adolescent girls and young women, and orphans and vulnerable children as well as building strong health systems, and tackling wider issues of poverty and inequality. 
  2. Improving financial transparency and accountability for children and adolescents is key to ensuring that money is invested wisely. PEPFAR have a gold standard financial tracking system where it is possible to see how much they spend on children and adolescents and for what interventions.  Meanwhile, the Global Fund has made tracking impact and resourcing for children a higher priority in its Modular Framework. We can learn a lot from the steps that PEPFAR and the Global Fund have taken.  Alongside this, it is vital to strengthen the voices of children, adolescents, caregivers, and those who deliver services in monitoring and making decisions regarding funds.
  3. Progress is possible even where funding is scarce. Making children and adolescents affected by HIV a political priority; supporting locally-led decision making on investments; ring-fencing funds for them within existing budgets; tracking and reporting on funding for them; prioritizing investments in cost-effective solutions that target those left furthest behind; and sharing costs with those seeking stronger systems for health will all make a difference.  

HAVE YOUR SAY

We urge you to write to key actors on the UNAIDS Programme Coordinating Board and would welcome you using our recommendations and messages:

  • Member States: Australia; India; Belarus; Iran (Islamic Republic); Botswana; Japan; Brazil; Kenya; Burundi; Libya; Cambodia; Mexico; China; Netherlands; Côte d’Ivoire; Russian Federation; Dominican Republic; Sweden; Finland; United Kingdom; France; United States of America.  To find the contact details of the Permanent Mission of each Member state please refer to the UN Blue Book.
  • UN Co-Sponsors: UNHCR; UN Women; UNICEF; ILO; WFP; UNESCO; UNDP; WHO; UNFPA; The World Bank. To find the contact details of the relevant agency please refer to the UN Blue Book.
  • The NGO Delegation:
  • Africa: SRHR Alliance Uganda & Zambia Network of Young People Living with HIV 
  • Asia/Pacific: APCOM Asia Pacific Coalition on Male Sexual Health & International Planned Parenthood Federation 
  • Europe: Eurasian Harm Reduction Association & Frontline AIDS 
  • Latin America/Caribbean: Jamaica AIDS Support for Life & Fundación Huésped  
  • North America: LetsStopAIDS & Transgender Law Center

More details on the NGO Delegation representatives are available here.

 

 1. https://bit.ly/DonorPolicyReport Stover, J. & Csaky, C. et al (2023) Donor Commitments to Children and Adolescents Affected by HIV and AIDS, The Coalition for Children Affected by AIDS
2. https://childrenandhiv.org/ The Coalition for Children Affected by AIDS is a global independent advocacy and learning coalition of senior leadership from across the UN, funder, NGO and academic communities all dedicated to equity for children and adolescents affected by HIV
3. https://childrenandhiv.org/blog/announcing-the-launch-of-a-new-project-to-create-a-roadmap-of-financial-investment-to-end-aids-in-children/