Perspectives on the pediatric HIV/AIDS pandemic: catalyzing access of children to care and treatment.

The successes of the United States and other developed countries in the prevention and treatment of pediatric HIV/AIDS have not been replicated in the developing world, where children continue to become infected with HIV and die from HIV/AIDS at astounding rates. Children are underrepresented among recipients of antiretroviral therapy in almost every setting worldwide where treatment programs have been established. The barriers to scaling up HIV/AIDS care and treatment globally are substantial. Nevertheless, nearly a decade after the introduction of pediatric highly active antiretroviral therapy in the United States, the opportunity finally exists to provide treatment to huge numbers of HIV-infected children in the developing world, changing forever the way that pediatric HIV/AIDS is perceived and managed. We propose the creation of a Clinical Centers of Excellence Network and Pediatric AIDS Corps of US pediatric health professionals, increased support for pediatric research relevant to resource-poor settings, commitment of the US government and others to proportionate funding for pediatric HIV/AIDS care and treatment, expanded availability of pediatric antiretroviral drug formulations, and a renewed commitment to collaborative partnerships as practical steps that can be taken to dramatically expand access of HIV-infected children and families in the developing world to health-restoring, life-prolonging care and treatment.