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Reprioritizing pediatric AHD on the global scale: A call to action from the 2024 IPHASA conference

Updated: 6 days ago


Introduction: The Global Challenge of Pediatric HIV and Advanced HIV Disease


Pediatric HIV continues to be one of the most pressing health challenges worldwide, with 1.4 million children living with HIV (CLHIV) in 2023. While significant strides have been made in prevention and treatment, many of these children still progress to advanced HIV disease (AHD), facing a higher risk of severe illness and death. For too many, timely access to diagnostics and optimal treatment remains a distant reality, especially in low- and middle-income countries (LMICs). There is an urgent need for a coordinated global effort to close the gaps in care and ensure no child is left behind.


The IPHASA Conference


The International Pediatric HIV/AIDS Symposium for Africa (IPHASA), held in Kampala, Uganda from December 3-5, 2024, was a landmark assembly addressing challenges in the pediatric HIV and AHD spaces. With the theme "Equity, Integration, and Innovation for a Sustainable HIV Response to End AIDS in Children by 2030," the conference was a call to action to ensure children are not overlooked in the broader HIV/AIDS response.


Group of people attending a conference.
Delegates pose with Uganda's Minister of Health, Hon. Dr. Jane Ruth Aceng at the IPHASA conference.

The conference brought together a diverse group of stakeholders, including ministry of health representatives and people living with HIV, alongside organizations such as WHO, PEPFAR, CHAI, and Penta. The symposium highlighted practical strategies to improve outcomes for CLHIV, focusing on strengthening service delivery, addressing social barriers, and ensuring equitable access to care.


A recurring theme throughout sessions was the need to address psychosocial challenges alongside clinical care. Community-driven approaches in Uganda and Liberia, such as caregiver-assisted self-testing and peer mobilizers, are boosting diagnoses and adherence among CLHIV. Integration of HIV services into broader healthcare systems, like Namibia’s triple elimination programs, emerged as another key example of effective programming. Across the conference, there was a strong emphasis on reducing health inequities through targeted interventions and innovative models, like Uganda’s hotspot analyses and community pharmacy distribution points, which are improving access to care in hard-to-reach areas.


Dr. Eleanor Magongo delivers opening remarks at IPHASA.
Dr. Eleanor Magongo delivers opening remarks at IPHASA.

By sharing lessons learned and best practices from across the continent, IPHASA equipped participants with actionable ideas to take back to their respective countries. However, the conference was about more than just exchanging knowledge, it was also about reigniting a collective commitment to push the pediatric HIV agenda forward. As Dr. Eleanor Magonogo from Uganda’s Ministry of Health said:


“We have to move what we know works into what we do on a daily basis to improve population health.”


This message resonated across the sessions: The knowledge is there. The solutions are within reach. Now it’s time to turn those lessons into action.


Presenting Unitaid’s THRIVE Project


IPHASA provided a stage to present ongoing activities under the THRIVE Project. THRIVE is funded by Unitaid and aims to reduce HIV-related morbidity and mortality among CLHIV across six countries: Kenya, Mozambique, Nigeria, South Africa, Uganda, and Zimbabwe. The THRIVE project led by CHAI, in partnership with Afrocab and Penta, shared strategies to address pediatric AHD service gaps and improve care through the implementation of the STOP AIDS package, which aims to Screen, Treat, Optimize, and Prevent AHD and associated opportunistic infections in CLHIV.


Dr. Pablo Rojo presents Penta's operational research alongside the THRIVE consortium.
Dr. Pablo Rojo presents Penta's operational research alongside the THRIVE consortium.

CHAI’s Dr. Vennie Nabitaka showcased progress from healthcare worker training sessions from the STOP AIDS package implementation in Uganda, encouraging collaborative learning and improved care delivery. Afrocab’s Margaret Happy reviewed how community consultations revealed fragmented service delivery, leading to a focus on amplifying community voices in national AHD discussions and ensuring that services are more responsive to local needs. Finally, Penta discussed how their operational research in Uganda, Mozambique, and Zimbabwe is identifying barriers and enablers to pediatric AHD care, helping optimize implementation strategies.


Spotlight on the Pediatric AHD Committee


Dr. Philippa Musoke, co-chair of the p-AHDc, shares insights on advancing pediatric HIV care.
Dr. Philippa Musoke, co-chair of the p-AHDc, shares insights on advancing pediatric HIV care.

In step with the momentum generated at IPHASA, the newly launched Pediatric Advanced HIV Disease Committee (p-AHDc) is working to reshape the global response to pediatric AHD. Created under the THRIVE project, the committee is facilitated by CHAI and co-chaired by Dr. Nandita Sugandhi, Medical Officer in WHO’s Global HIV, Hepatitis, and STIs Programs, and Dr. Philippa Musoke, Executive Director of the MU-JHU Research Collaboration. It aims to elevate AHD care for children and adolescents by developing a forum for expert feedback on the pediatric activities supported by Unitaid’s investments in AHD, including THRIVE and the Aurum Institute's IMPAACT4HIV project, while also facilitating knowledge-sharing and collaboration in the space.


During the conference, p-AHDc members underscored the alignment with the conference’s guiding theme of improving pediatric HIV outcomes. Reflecting on the significance of the event, Rebecca Bak, Medical Officer in CDC’s Maternal Child Health Branch, Division of HIV & TB, Global Health Center, shared her impressions:


“It was inspiring to be a part of such a diverse and motivated group focused on tackling the challenges of AHD diagnosis, treatment, and prevention among children and adolescents living with HIV.  I hope that p-AHDc will continue to build on this momentum and serve as a key platform for uniting diverse expert voices in addressing via concrete actions this urgent health challenge.”


Looking Ahead: Strengthening Partnerships for the Future


Both IPHASA and the p-AHDc underscore the desire for collaboration to accelerate reductions in pediatric morbidity and mortality. The partnerships formed at the conference, alongside the committee’s ongoing work, will be essential in amplifying global and national activities to address pediatric AHD. Speaking to the urgency of this mission, p-AHDc co-chair Dr. Nandita Sugandhi stressed the need for immediate action:


“We have all the tools to prevent HIV-related mortality and morbidity, yet children continue to die. To look away would be unconscionable. Now is the critical moment to redirect our attention and resources toward children living with HIV. We need platforms such as IPHASA and collaborations such as the p-AHDc to drive this urgent refocus and translate it into action.”


As we look ahead, the p-AHDc aims to continue engaging governments, donors, implementing partners, and communities to support implementation. By leveraging the lessons learned and sharing best practices from the THRIVE project implementation, the committee is poised to drive impact in the efforts to end pediatric AHD.



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