This proposed investment aims to address the unfinished business of paediatric and adolescent HIV in KwaZulu-Natal by using a quality improvement strategy to accelerate the identification and enrollment of HIV positive children and adolescents on treatment, and ensuring that clinical and community care and linkages is improved so that they are retained in care. This is a unique opportunity to build on the momentum created by the national commitment to reach 90% ART coverage, and prevent new HIV infections in adolescent girls and young women.