Twenty-four years ago, we began our work in western Kenya with a simple but urgent mission: protect the lives of children in communities carrying one of the highest HIV and malaria burdens in the world.
At the time, pediatric HIV was almost always a death sentence.
We were working primarily in pediatrics-inside district hospitals, rural clinics, and community outreach programs-where we saw firsthand how devastating the epidemic was for families. Infants were becoming infected at birth, yet the tools to diagnose and treat them simply did not exist in meaningful ways.
What we encountered was a cruel paradox: the very antibodies passed from mother to child to protect infants made HIV nearly impossible to diagnose during the years of life. Standard rapid tests for HIV could not distinguish between maternal antibodies and true infant infection. Waiting for those antibodies to clear-often 18 to 24 months-meant waiting too long. More than 83% of HIV-infected children died before the age of three years, most before a definitive diagnosis could even be made.
We knew that if early diagnosis was impossible, survival was impossible.
Building the First Pediatric Molecular Testing in the Region
To change this reality, we established one of the first pediatric molecular HIV testing platforms in western Kenya.
Working with local clinicians and laboratories, we introduced PCR-based diagnostics capable of detecting the virus itself-not just antibodies. We developed the assay against the three most common viral clades circulating in the region, ensuring accuracy for local transmission patterns. This was not just a technical upgrade; it was a lifeline.
Our approach was practical and scalable:
Rapid tests were used as the first screening tool in infants and children.
Positive screens were then confirmed using PCR, providing a definitive diagnosis months or even years earlier than previously possible.
For the first time, families could receive clear answers. Clinicians could identify infected children before symptoms became severe. And most importantly, the scale of the crisis became impossible to ignore
When Diagnosis Outpaced Treatment
But there was a devastating reality behind every test result.
At that time, pediatric antiretroviral therapy simply did not exist in these communities. Even with definitive diagnosis, nearly 100% of children born with HIV died quickly. We were identifying the problem, but the world had not yet provided the tools to treat it in sub-Saharan Africa.
Yet those diagnoses changed everything.
By documenting the true burden of pediatric HIV, our work helped demonstrate what had long gone unseen: infants were dying not because treatment was ineffective, but because it was unavailable. This evidence became a catalyst for action.
From Evidence to Access
As global partners, ministries of health, and international donors confronted the data, pediatric HIV could no longer be treated as an afterthought. The availability of reliable molecular testing accelerated efforts to develop and distribute child-appropriate antiretroviral formulations.
When treatment finally became accessible, we were ready.
We established one of the first pediatric HIV testing and treatment programs in western Kenya, integrating early diagnosis, clinical care, and community follow-up. Children who once had no chance at survival were now starting therapy. Families who had lost hope were given something profoundly powerful: time.
A Model Built on Community and Science
From the beginning, our work was rooted in partnership.
We trained local healthcare workers, strengthened laboratory infrastructure, and worked alongside community leaders to reduce stigma and increase trust in care. Families were no longer navigating HIV alone; they were supported by a system designed to serve them.
What started as a response to a pediatric crisis became a sustainable model for HIV care-combining scientific innovation with community-based delivery.
Looking Forward
Today, the landscape of HIV in Kenya is transformed. Early infant diagnosis is standard. Pediatric antiretroviral therapy saves countless lives. And children born with HIV can now grow into adulthood.
But high-burden communities still face barriers: gaps in access, late diagnoses, treatment interruptions, and structural inequities that leave the most vulnerable behind.
Our mission remains what it was 24 years ago—to ensure that no child is denied care because of where they are born.
By closing the HIV treatment gap through science, partnership, and trust, we are not only saving lives.
We are building healthier futures for the next generation.
