Closing the gap in paediatric HIV infections: how available tools and technology can accelerate progress towards ending AIDS by 2030
Despite declining HIV incidence and AIDS-related deaths globally, progress against HIV elimination remains fragile in many countries and acutely inadequate among priority populations, such as children and adolescent girls and young women, especially in low-income and middle-income countries. The global agenda of Ending AIDS by 2030 elaborated by the Global AIDS Strategy 2021–2026 is a strong and bold declaration to reduce inequalities that drive the AIDS epidemic and prioritise pregnant and breastfeeding women and their children, who remain more vulnerable to HIV acquisition than other groups. Although progress in reducing mother-to-child transmission (MTCT) of HIV has been remarkable since the introduction in 2011 of the Global Plan towards the Elimination of New HIV Infections among Children and Keeping their Mothers Alive, it is now clear that the current rate of reduction is not fast enough. Although a majority of pregnant and breastfeeding women living with HIV are on antiretroviral therapy, many incident HIV infections are being missed. Indeed, HIV transmission during breastfeeding accounts for more than half of all new paediatric HIV infections worldwide. To eliminate new paediatric infections and reach global targets, new approaches are urgently needed.