Reaching the Tipping Point on Pediatric AIDS

We are nearing the tipping point with pediatric AIDS, the moment when an HIV-free generation is possible. It cannot happen if we stop now.
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With the recent passing of Nelson Mandela, I am reminded that the world of the present does not have to be the world of the future. Nelson Mandela demonstrated that people of vision and action can dramatically change the conditions of life for millions of their fellow human beings. I was in Cape Town, South Africa, when I learned of President Mandela's passing, and I immediately reflected upon how much that country had changed in the generation since those bleak days when the majority of the country lived under the oppression of apartheid, and the future president was imprisoned "for life" in a tiny cell on Robben Island, visible from the Cape Town beaches.

Through the leadership of Nelson Mandela and others, and the actions of countless individuals, South Africa reached a tipping point at which freedom, which once seemed impossible, became inevitable. In 2013 we saw our own "tipping" point with regard to the AIDS pandemic -- and real progress around a global plan to end pediatric AIDS -- bringing us closer each day to a world where no child has AIDS.

Last month I was in Cape Town to speak at the International Conference on AIDS and STIs in Africa (ICASA) and to represent the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). The conference theme, "Now More Than Ever: Targeting Zero," envisioned a dramatically different future in which there are "zero new HIV infections, zero discrimination and zero AIDS-related deaths." Throughout the many sessions of the conference, a consensus emerged to ensure access to HIV treatment for everyone living with the virus, regardless of his or her ability to pay for the treatment. Vision like this -- combined with action--can dramatically change the world.

In June, the President's Emergency Plan for AIDS Relief (PEPFAR) announced that 13 new countries had reached the programmatic "tipping point" in the fight against HIV/AIDS -- meaning more people are now on treatment than are newly infected -- a true sign of progress. Efforts to end pediatric AIDS have also been bolstered by success of the Global Plan Towards Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive. The plan has helped to focus and catalyze efforts at the country level -- Botswana, Ethiopia, Ghana, Malawi, Namibia, South Africa and Zambia have reduced new HIV infections among children by 50 percent since 2009. Tanzania and Zimbabwe are also making substantial gains.

While we celebrate these successes, we must remember that 700 children continue to be born with HIV every single day. And in 2012, only 34 percent of children in the Global Plan's 22 priority countries in need of antiretroviral treatment were receiving it. We are nearing the tipping point with pediatric AIDS, the moment when an HIV-free generation is possible. It cannot happen if we stop now. We need to step up efforts to provide treatment for HIV-positive mothers and HIV-exposed children. We need to use the successes of 2013 to build a platform for continued momentum in 2014 and beyond.

After his presidency, Nelson Mandela was an unflagging foe of HIV, driven in part by the fact that he was personally touched by the virus; his son was felled by it. "AIDS is no longer just a disease," President Mandela said at a 2003 concert in Cape Town, "it is a human rights issue."

As we enter the New Year, join me as we continue to push for a true tipping point on pediatric AIDS -- and to end AIDS in children, once and for all.


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