PEPFAR Pediatric HIV treatment partnership targets antiretroviral access gap

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Slide 33: Numbers tell a story when you graph them, Birx says.

U.S. President’s Emergency Plan for AIDS Relief with London-based philanthropy Children’s Investment Fund Foundation aims to double number of children getting lifesaving medicine across 10 African countries in next two years

“When you just see a number, you don’t always grasp a problem,” U.S. Global AIDS Coordinator Ambassador Deborah Birx said, the day after announcing the launch of ACT —  Accelerating Children’s HIV/AIDS Treatment — an initiative focused on reaching the most vulnerable and overlooked victims of the global AIDS pandemic. But when you put it on a graph, she continued, it tells a story. The story of slide number 33 in a set she looked at recently tells a story of vast discrepancy and missed opportunity.

“It shows you that even in countries that have been enormously successful with adult treatment coverage, like Rwanda, Zambia, Namibia, you can see the children’s coverage of  [antiretroviral treatment] is 20, 30, 40 percent less,” Birx said. But she added, “there’s some countries where its completely matched — Botswana, South Africa.”

On a graph, in short, the numbers show it can be done. Birx has enumerated the obstacles before — starting with the difficulties of  treating children with bad-tasting, hard-to-store medicine that wasn’t formulated for their needs. The stigma still associated with HIV is another, along with the invisibility of children in countries where vital record keeping is challenged. The challenge of keeping any adolescent on track adds further to a deadly gap in treatment coverage between adults and children.

“The one shocking figure we’ve seen in the last few months,” Birx notes, “is that HIV/AIDS is the largest killer of young adolescents. That tells us that we’re not reaching them until they’ve become very sick with HIV.”

With $150 million from PEPFAR, and $50 million from the London-based philanthropic Children’s Investment Fund Foundation — CIFF — Birx is volubly excited about changing that. Reaching more children will encourage the development of formulas for children, she believes. She also is hopeful that the focused effort to reach children and save their lives will make a difference in how HIV is perceived, sending, she says “a signal that we’re concerned about the whole family, and hopefully decrease the stigma and discrimination.”

The partnership with CIFF is not PEPFAR’s largest to date, but it is among them. Birx hopes for more partners from all sectors — government, donor and private sector — and is optimistic. CIFF, she says, has emphasized the importance of data transparency — traditionally not a strength of PEPFAR, which reports have found to be one of the least transparent donor agencies in the world, and in the past less forthcoming with data than the U.S. State Department and Department of Defense. That has changed rapidly in the last few months, Birx says, with the PEPFAR dashboards, which put planning, impact and expenditure data on display. CIFF’s partnership, Birx says, “is a real validation of PEPFAR being more transparent.” That, in turn she says, will attract more partners.

The initiative is set to begin in the fall. Birx was on her way, today, for a talk with the foundation, to select the exact 10 countries, she said, where the plan can have the greatest impact on the greatest need — perhaps with some help from slide 33.

One thought on “PEPFAR Pediatric HIV treatment partnership targets antiretroviral access gap

  1. Pingback: Study sets out to capture pediatric antiretroviral treatment costs, improve planning | Science Speaks: HIV & TB News

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