The Living Legacy of the Global Plan
April 20, 2017
The Journal of Acquired Immune Deficiency Syndromes (JAIDS) has released a special supplement on the incredible journey of the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan), which documents the history of the Global Plan and outlines what the future holds as efforts to end AIDS among women, children and adolescents accelerate.
The Global Plan began with the simple but powerful premise that "children everywhere can be born free of HIV and their mothers remain alive". Although this goal may not seem radical today, when the Global Plan was launched it seemed unimaginable.
In 2009, there were 270 000 new HIV infections among children in the 21 Global Plan priority countries, only 36% of pregnant women living with HIV had access to recommended antiretroviral medicines to prevent transmitting the virus to their child and just 15% of children living with HIV had access to life-saving antiretroviral therapy.
It was in response to this injustice that UNAIDS and the United States President's Emergency Plan for AIDS Relief (PEPFAR) led a global effort to stop new HIV infections among children and ensure their mothers stay alive and healthy. On 9 June 2011, during the United Nations High-Level Meeting on AIDS, the Global Plan was formally launched.
The global community's response to this call to action was immediate. PEPFAR and private sector partners pledged funding for the Global Plan and countries, civil society, the private sector, the faith-based community, networks of people living with HIV, and international organizations all joined forces to chart a bold course for a country-led movement to create an AIDS-free generation.
The Global Plan was transformative and the progress which ensued, remarkable. The Global Plan helped to drive a 60% reduction in new HIV infections among children, avert 1.2 million new infections among children and halve the number of AIDS-related deaths among women of reproductive age in 21 priority countries in Africa from 2009 to 2015.
Over the course of the Global Plan, seven countries reduced new HIV infections among children by more than 70% (Uganda by 86%, Burundi by 84%, South Africa by 84 %, Swaziland by 80%, Namibia by 79%, Mozambique by 75% and Malawi by 71%).
However, progress has been uneven. In a number of countries (Angola, Côte d'Ivoire, and Nigeria), new paediatric HIV infections declined by less than 40% over this same period. Every year, 110 000 children are still acquiring HIV in the 21 Global Plan priority countries, and 150,000 worldwide. More than half of new paediatric HIV infections occur during the breastfeeding period. Testing and treatment coverage among children remains too low and alarming numbers of adolescent girls and young women are still becoming infected.
This is why, in June 2016, PEPFAR and UNAIDS once again joined forces and launched Start Free Stay Free AIDS Free to accelerate the momentum driving this ambitious agenda, bring even greater urgency and focus to the work ahead and galvanize global solidarity around a shared and ambitious agenda to end AIDS among children, adolescents and young women.
The articles that comprise the JAIDS supplement trace the tremendous evolution and impact of the Global Plan across various domains, highlighting examples of bold leadership, innovation, and activism. They also capture the growth of a learning agenda, continually building on new developments in science, and translating these into lifesaving services. Together, they represent a living legacy of what has been done -- and what must still be done -- to reach our ultimate goals: controlling and then, finally, ending the AIDS epidemic as a public health threat by 2030 within the framework of the Sustainable Development Goals.
-- Michel Sidibé, executive director of UNAIDS, and Ambassador Deborah L. Birx, United States global AIDS coordinator
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