The Free to Shine campaign1 is an initiative of the African Union, the Organization of African First Ladies for Development (OAFLAD) and partners to address the growing complacency in the response to childhood HIV in Africa. The campaign aims to leverage the unique engagement and advocacy of first ladies in Africa, reinforcing the political commitment of African leadership, to end childhood HIV and keep mothers healthy. Preventing new HIV infections and AIDS-related deaths among children, adolescent girls and women remains hugely important, and the commitment of OAFLAD, the African Union and their partners is essential to advancing this global goal. Important gains have been made in the AIDS response for women and children. An estimated 1.5 million new HIV infections among children aged 0–14 years have been averted since 2010 in Africa. The proportion of pregnant women living with HIV receiving antiretroviral therapy has increased from 44% in 2010 to 84% in 2018. Nine countries—Benin, Botswana, Burkina Faso, Malawi, Mauritius, Mozambique, Namibia, Rwanda and Zambia—have achieved the 2018 coverage target of 95% of pregnant women living with HIV on antiretroviral therapy. However, challenges remain across Africa. Progress in preventing new HIV infections and AIDS-related deaths among children has stalled. AIDS remains the leading cause of death among women of reproductive age. Only half of all children living with HIV have access to antiretroviral therapy. Coverage of services to prevent vertical transmission of HIV has stalled in eastern and southern Africa and decreased in western and central Africa in the past three years.

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