“Healing is a matter of time, but it is sometimes also a matter of opportunity.” The Greek physician Hippocrates wrote this in about 400 BC. Of course, when Hippocrates practiced medicine, opportunities to heal were scarce as he and his peers understood relatively little about anatomy and physiology, much less biomolecular science. In Hippocrates’ era, some percentage of young children were expected to succumb to illness. Over the last 2,000 years, however, developments in medical science have allowed for the previously unthinkable. The collective brilliance and hard work of scientists and healers have ensured that many of the maladies that afflicted Hippocrates’ patients took a one-way trip to the history books.  Children, for the most part, can be expected to reach adulthood.

Alas, some exceptions stubbornly remain.

There is no clearer example than pediatric HIV. A single generation has seen the rise of a devastating epidemic and, though there have been breakthroughs in the fight against the virus, 3.2 million children currently live with the virus and an estimated 700 children are infected daily. The recent, sudden viral rebound in the “Mississippi baby,” the first child believed to be functionally cured, was the latest punch to the gut in the long, drawn out brawl to protect children from the virus. In low-resourced regions, children living with HIV are often among the last to be tested and treated. Initiating children on treatment early, which allowed the Mississippi baby to remain virally suppressed for years, is exceptionally rare.

A baby receives life-saving drugs. / Anna Zeminski, AFP / Getty Images

A baby receives life-saving drugs. / Anna Zeminski, AFP / Getty Images

Now for some good news. Earlier this month, as part of the U.S.-Africa Leaders Summit, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR),in partnership with the Children’s Investment Fund Foundation (CIFF), launched Accelerating Children’s HIV/AIDS Treatment (ACT). ACT is an ambitious $200 million initiative to double the total number of children receiving life-saving antiretroviral therapy (ART) across 10 priority African countries over the next two years. This investment will enable 300,000 more children living with HIV to receive life-saving ART.

At the onset of the HIV epidemic in the early 1980’s, an HIV diagnosis was equivalent to a death sentence. Failing to treat a child remains just that, as half die by 2 years of age. Up to three people die of AIDS every minute and an estimated 190,000 children died of AIDS in 2013 alone.


An HIV-positive mother holds her child after visiting an HIV clinic. For children who are born HIV-positive, life-saving antiretroviral therapy is critical to protecting their health. / AFP

Hippocrates was right: Healing is indeed both a matter of time and opportunity. Time does not heal HIV, however, and deaths continue to mount, a disproportionate number of them among children.

So, now is the time to act. Thanks to PEPFAR and CIFF, we have an unprecedented opportunity to do just that.


Dr. Benjamin Ryan Phelps is a Medical Officer who focuses on Preventing Mother-to-Child Transmission of HIV (PMTCT) and Pediatric AIDS. Follow him at @BRPhelpsMD.
Joella Adams is a Global Health Fellows Program intern working with PMTCT programs.