On 13 June 2025, the Democratic Republic of the Congo (DRC) took a significant step in the fight against paediatric HIV. During the closing session of the Governors’ Conference in Kolwezi, President Félix Tshisekedi launched the Presidential Initiative for the Elimination of HIV/AIDS among Children.

This bold five-year programme represents an important shift: an acknowledgement that children must be at the centre of the national HIV response, and that this requires dedicated domestic resources, provincial accountability, and innovative local solutions.

Despite remarkable progress in HIV treatment for adults, where approximately 91% of people living with HIV in the DRC now have access to lifesaving antiretroviral therapy, children have been left behind. Only 44% of children living with HIV currently receive treatment. This gap has persisted for over a decade.

Tackling Persistent Barriers.

The Presidential Initiative aims to address longstanding challenges that have fueled new infections and prevented early treatment:

• Low access to quality sexual and reproductive health services for women and girls.
• Weak integration of HIV services with maternal, neonatal, child and adolescent health platforms.
• A fragile supply chain for medical products.
• Insufficient coordination between community actors and public health services.

Through targeted investment and a clear accountability framework, the initiative sets out to:

• Improve early HIV screening and treatment for children, adolescents, and pregnant and breastfeeding women.
• Prevent new HIV infections in children and mothers.
• Ensure all HIV-positive adolescent girls and women rapidly start treatment
• Dismantle structural barriers limiting service access for adolescents.

Catalysing Domestic Resource Mobilisation.

One of the initiative’s most significant breakthroughs is its funding model. Backed by at least $18 million in national resources, the programme explicitly prioritises local leadership. This catalytic funding is intended not only to close the treatment gap, but to inspire provinces to invest sustainably in health.

Indeed, in a historic show of political commitment, all 26 provincial governors signed a Final Declaration, pledging to:

• Align provincial budgets with the Abuja Declaration target of allocating 15% to health.
• Dedicate 20% of provincial health budgets to HIV programmes, with a focus on paediatric services and treatment.
• Encourage public-private partnerships to bridge remaining funding gaps.

These commitments mark a turning point: an understanding that sustainable financing and domestic resource mobilisation are not optional, but essential.

A Shared Responsibility.

While national and provincial governments will lead implementation, civil society and international partners (including EGPAF, UNICEF, and UNAIDS) have played an important role in sustained advocacy. But this moment is ultimately about African solutions for African challenges, owned by Congolese institutions and communities.

As the DRC embarks on this journey, the message is clear: ending paediatric AIDS is possible, but it requires that domestic funding be prioritised, health budgets be protected, and local innovation be empowered.