Remarks at a UN High-Level Side Event on Ending Inequalities for Children in the AIDS Response: Fighting Complacency and Closing the Gaps

Dr. Angeli Achrekar
Acting Global AIDS Coordinator
U.S. Department of State
Washington, D.C.
June 8, 2021


Good morning. Winnie said it so powerfully in the opening plenary earlier today – inequalities kill. And children are among those who are bearing the burden.

The United States remains deeply committed to ending the HIV epidemic, including ending inequalities for children through the President’s Emergency Plan for AIDS Relief or PEPFAR. Preventing mother to child transmission, finding undiagnosed children living with HIV, and ensuring all children and adolescents living with HIV receive optimal care and treatment have been key tenants for PEPFAR since our inception.

But as we noted earlier today during the political declaration deliberations – outdated and ineffective interventions must be dropped and replaced with those that effectively reach key populations, adolescent girls and young women, and children. These populations – these individuals – remain at risk for HIV and have clear unmet needs. We must meet those needs.

As we see stagnant progress in HIV prevention and treatment for children and pregnant women, PEPFAR has and will continue to intensify our efforts to address these inequalities. In many cases we have the tools and strategies necessary to prevent HIV transmission and to identify and treat children living with HIV, but programs have struggled with fully scaling these strategies. Renewed visibility, commitment, and policies on pediatric HIV/AIDS are urgently needed from national and community-level leaders to close the gap for pregnant women and children.

Given the urgent need to redouble global efforts to deliver an AIDS-free future for children, we are rapidly deploying better dolutegravir-based ARV regimens for children, expanding early infant diagnosis/viral load point of care testing, relying on partnerships between orphans and vulnerable children and clinical partners to support the pediatric care continuum, expanding multi-month dispensing of antiretroviral therapy, and differentiated service delivery models to improve family centered care. Specifically, in the context of COVID-19, PEPFAR has made quick program adaptations to ensure children and women are not left behind.

While we are deeply distressed by the global pediatric HIV shortfalls, we are also encouraged by the fact that we largely have the tools and the political will we need to change this. So, let this be a call to action for all of us attending this event to always challenge complacency and to work tirelessly to close the gap! We are incredibly grateful to our co-sponsors and speakers for realizing this powerful and impactful event and we are honored to partner with all of you on this journey to ending pediatric AIDS by 2030.