Children and adolescents living with HIV-AIDS continue to be left behind in access to early diagnosis, life-saving treatment and care, as shrinking funding threatens to increase their risks and reverse decades of progress, Unicef warned ahead of World AIDS Day.
A recently published Unicef-UNAIDS modelling shows that, if programme coverage falls by half, an additional 1.1 million children could acquire HIV, and 820 000 more could die of AIDS-related causes by 2040 – pushing the total toll among children to three million infections and 1.8 million AIDS-related deaths.
Even maintaining current service levels will still result in 1.9 million new infections and 990 000 AIDS-related deaths among children by 2040 due to the slow pace of progress, according to the modelling.
“The world was making progress in the HIV response, but persistent gaps remained even before abrupt global funding cuts disrupted services,” says Unicef associate director of HIV-AIDS Anurita Bains.
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“While countries moved quickly to mitigate the impact of the funding cuts, ending AIDS in children is in jeopardy without focused action. The choice is clear – invest today or risk reversing decades of progress and losing millions of young lives.”
These projected risks underscore findings from the latest 2024 global data, before abrupt funding cuts disrupted many services globally.
About 120 000 children (0 to 14 years) acquired HIV, and another 75 000 children died of AIDS-related causes – about 200 deaths every day.
Among 15-19-year-olds, 150 000 acquired HIV, of which 66% were among girls. In sub-Saharan Africa, 85% of new HIV infections in this age group are among girls.
Only 55% of children living with HIV received antiretroviral therapy, compared to 78% of adults, leaving an estimated 620 000 children without treatment.
Sub-Saharan Africa bears the heaviest burden, accounting for 88% of children living with HIV, 83% of new child HIV infections, and 84% of AIDS-related child deaths.
In eastern and southern Africa, early infant diagnosis reached 74% of exposed infants and treatment reached 93% of pregnant women living with HIV, compared to 31% and 56%, respectively, in western and central Africa.
However, progress is possible with sustained commitment. Between 2000 and 2024, HIV-AIDS services averted an estimated 4.4 million infections and 2.1 million AIDS-related deaths in children.
By the end of 2024, 21 countries and territories had been certified for eliminating vertical transmission of HIV and/or syphilis, with the Maldives becoming the first to eliminate vertical transmission of HIV, syphilis and hepatitis B.
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Botswana and Namibia were certified as on the path to elimination despite high HIV burdens.
Unicef urges governments and partners to protect and prioritise HIV-AIDS services for mothers, children and adolescents – scaling up prevention of mother-to-child transmission and paediatric treatment, and integrating HIV care into broader health systems – and ensuring increased and predictable donor support through sustainable and innovative financing.
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