An estimated 2.1 million children under 15 years old were living with HIV in 2008, and an estimated 280,000 children died of largely preventable AIDS-related causes. About 38 per cent of children in need of antiretroviral therapy (ART) received it, up from 10 per cent in 2005. Access to HIV treatment for children is still low in most countries, although progress has been observed in every region of the world. Without treatment, 50 per cent of infected infants die before the age of 2.

In high-income countries, routine access to prevention of mother-to-child transmission of HIV (PMTCT) programmes has cut rates of transmission to about 2 per cent. In lowand middle-income countries, however, only 45 per cent of the more than 1.4 million pregnant women living with HIV in 2008 received antiretrovirals for PMTCT, well short of the target of 80 per cent by 2010 that was set at the United Nations General Assembly Special Session on HIV and AIDS (2001). The proportion of infants born to HIV-infected mothers receiving antiretrovirals for PMTCT was even lower, at 32 per cent, although this was up from 12 per cent in 2005.

There is growing momentum behind a concerted scale-up of coverage, although progress is hampered by weak health systems in heavily affected countries – 80 per cent of children under 15 needing ART live in 20 countries in sub-Saharan Africa and Asia. Community mobilization and family support for HIV-positive women are urgent priorities, as is better integration of PMTCT services into stronger systems of maternal, newborn and child health care.