In the Pediatric Antiretroviral Pipeline Polly Clayden shows us that developing "new antiretroviral drugs and appropriate formulations for children continues to be far too slow;" and that 40% of children on ART are on suboptimal regimens. Among noteworthy steps forward are the inclusion in the new WHO guidelines of integrase inhibitors, efavirenz 400mg and dolutegravir as alternatives for adolescents, raltegravir as recommended second-line for children, and dolutegravir and darunavir/ritonavir for thirdline, and FDA approval of dolutegravir tablets for children aged 6 to 12. New solid lopinavir/ ritonavir pellets are now approved for infants and young children, but apparently don't taste very good. Priority formulations identified back in 2013 remain lacking, including AZT or abacavir (ABC) plus 3TC and lopinavir/r and ABC with 3TC and efavirenz. Additional priority formulations from 2014 remain unavailable. Clayden reviews ongoing and planned trials to address gaps in treatment options for newborns [see Table 3: Newborn treatment options (or lack of options to date): including ongoing and planned IMPAACT trials), children, and adolescents. The current pediatric ARV pipeline is shown in Table 4: The pediatric antiretroviral pipeline.