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The scaling-up of successful universal treatment for pregnant women has reduced the number of new infant HIV infections, however children and adolescents are not being diagnosed and treated early enough to prevent HIV-related morbidity and mortality. PEPFAR continues to focus on addressing the key challenges in reaching this population with critical HIV services. Many more children are now on treatment thanks to PEPFAR’s ACT Initiative, but treatment coverage and viral suppression among children and adolescents remain a challenge. As such, PEPFAR continues to formalize partnerships to rapidly increase the number of asymptomatic children found, tested and maintained on life-long treatment.

In 2014, PEPFAR and the Children’s Investment Fund Foundation launched the $200 million Accelerating Children’s HIV/AIDS Treatment (ACT) Initiative to initiate an additional 300,000 children living with HIV on ART in nine PEPFAR priority countries. At the end of the partnership in September 2016, an additional 561,610 children were accessing treatment in those nine countries. This partnership was a major step towards increasing the number of children on treatment.

As a follow-on to PEPFAR’s remarkable impact with the ACT Initiative, PEPFAR saw the need to facilitate and expedite the research, development, approval, introduction and uptake of optimal drugs and formulations for infants, children, and adolescents. PEPFAR joined the Holy See and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to convene a series of High-Level Dialogues with leaders of major diagnostic and pharmaceutical companies, multilateral organizations, governments, regulators, faith-based organizations, and others who are directly engaged in providing services to children and adolescents living with and vulnerable to HIV. During these dialogues, key stakeholders agreed to specific good faith commitments to focus, accelerate, and collaborate on the development, registration, introduction, and roll-out of the most optimal pediatric formulations and diagnostics.

The generous support from pharmaceutical and diagnostic manufacturers is critical to expanding access to lifesaving HIV therapy for children in the resource-poor settings. Specifically, these companies committed to developing and gaining regulatory approval for specific life-saving drugs and diagnostic tools, including distributing pediatric formulations in select countries. These efforts will be instrumental in reducing new HIV infections to under 20,000 children by 2020, as called for by the Super Fast-Track Targets.

PEPFAR depends on the dedication of all sectors – governments, donors, private sector, pharmaceutical, faith-based, and community partners – in order to reach more children in need with safe, effective, and affordable HIV testing and treatment before they get sick.

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