Anew report says the global response to HIV/AIDS has failed to meet the needs ofmillions of children and their families. It recommends new approaches tosimultaneously address HIV/AIDS, poverty, food insecurity and social inequity.
Thereport is called Home Truths: Facing the Facts on Children, AIDS and Poverty.It's a two-year study done by an independent alliance of researchers,policymakers, activists and others called the Joint Learning Initiative onChildren and HIV/AIDS.
Aco-chair of the alliance is Jim Yong Kim, director of the FXB Center for Healthand Human Rights at Harvard University.
"Thisis a global report. But we focused primarily on the countries of sub-SaharanAfrica that are confronting a severe AIDS epidemic," he says.
Thereport finds that families provide the best care for children. Yet despitebearing up to 90 percent of the cost, they receive little or no financialassistance from governments.
Italso finds that extreme poverty is a barrier to the increase of AIDS services.And while HIV infection rates are often highest among women and girls, notenough is being done to address the social conditions and norms that make themmore vulnerable.
Kimsays that while AIDS treatment and prevention have "revolutionized" theapproach to health care in developing countries, a new direction is still needed.
"There-direction of the AIDS response to serve families and communities, especiallyin those communities that are hardest hit, can be the motive for strengtheninghealth services and social protection for the poorest and most vulnerable,especially the children and their families," he says.
Thetwo-year study looked closely at HIV infection rates among children.
"So, what did we find when we looked at how childrenare faring in this epidemic? Statistics show that, one, over 90 percent of themore than two million children living with HIV are infected before or duringbirth. Yet, only one in three pregnant women with HIV in low and middle-incomecountries gets the treatment they need to help prevent infection of theirbabies. And still, only a very small proportion of children living with HIVreceive the life-saving anti-retroviral treatments," he says.
What'smore, fewer than 10 percent of children born to HIV-positive women are testedfor the AIDS virus before they're two months old.
Thereport also finds that most children labeled AIDS orphans in sub-Saharan Africaactually have a surviving parent or other family member willing to care forthem. But those potential caregivers often lack the basic resources to give thechildren what they need.
Kimsays, "Resources, though, are currently not reaching the families that needthem. And in the most severely affected region families and communities pay 90percent of the financial cost of caring for children affected by the epidemicwith little or no assistance from government."
Extremepoverty is blamed for blocking their access to AIDS-related programs, with over60 percent of children in sub-Saharan Africa living in poverty.
Kimsays, "In countries in which HIV is endemic, the disease impoverishes entirecommunities. When we make relief too narrowly AIDS specific, we miss a largeportion of children impoverished by the epidemic. In fact, only providing benefitsfor people living with HIV or with family members, who are living with or diefrom HIV, is probably counterproductive. It can create stigmatization and abusefor those in need of help."
Kimsays family care is always preferable to institutional care, such asorphanages.
The Joint Learning Initiative on Children and HIV/AIDSrecommends greater financial support for children and their families; a greaterfocus on children's needs, not their HIV status; ensuring the physical safetyof girls and women at school, on public transport and places of recreation; andaddressing behavior and attitudes that encourage sexual abuse.