DURBAN, South Africa, Aug 5 (AFP) - Sub-Saharan Africa faces a catastrophic increase in the number of children orphaned and infected by AIDS unless treatment is improved, a leading South African paediatrician warned on Tuesday.
Razia Babot, a researcher at the University of Natal, was speaking at a four-day AIDS symposium in the east coast city of Durban.
"With absolutely no treatment there will be 20 million AIDS orphans in sub-Saharan Africa by 2010," Babot said.
"But there will be treatment and obviously we will not have such a problem," she said.
Her comments come as the South African government is facing growing criticism over delays in the promised establishment of a national treatment programme for the disease, and the HIV virus that causes it.
The South African Medicines Control Council has helped rekindle the controversy over the government's policy on AIDS by threatening to ban nevirapine, an anti-retroviral (ARV) drug widely used in the treatment of AIDS and recommended by the United Nations as a way of reducing transmission of the disease from mother to child.
Besides the obvious human suffering that would result from an explosion in the number of AIDS orphans, Babot said, it would also impose massive new costs on already-strained health budgets.
"Paediatrics costs a lot more than treating adults," she said, adding that most HIV-infected children in South Africa did not even have access to adequate nutrition.
"There are also complicated treatment regimes, like strict meal times which have to be adhered to, but which are difficult to enforce," Bobat told around 1,000 delegates at the conference.
"Nutrition for HIV-positive children is a high priority, but is often neglected. Improving it is important because good nutrition is the key to anti-retroviral therapy."
By the end of 2001 there were already 250,000 South African children under 15 living with HIV/AIDS, according to UN figures, while 660,000 children had been orphaned by the disease.
Bobat said research had shown that low-cost dietary supplements could be used effectively to promote weight gain in HIV-positive children.
"To be successful, we need to look at low-costs diets, make sure that nutrition is in place and then use ARV therapy," she said.
"As we progress with mother-to-child-treatment, the number of HIV infected children will come down, and it will be an easier problem to handle."
AIDS researcher Anne Barnard gave the conference details of a study she had carried out into children caring for terminally ill parents -- most suffering from AIDS -- in the Ingwavuma district in eastern KwaZulu-Natal province.
"The youngest child we came across that was the sole person taking care of the parent was four years old," she said.
"In most of the cases the children were doing an adequate job of taking care of the adult, but they also complained that they were tired at school or even unable to attend classes."
Earlier, a health official urged the Pretoria government to "refocus" its budget and provide anti-AIDS drugs that could save the lives of five million infected citizens.
"If there is not a large-scale solution, five million South Africans will die in 10 years. No country can survive a calamity like this," said the director general of health in South Africa's Western Cape province, Fareed Abdullah.
"South Africa's Treasury needs to refocus its budget allocation to emphasise spending on AIDS," he said to loud applause. "No AIDS programme can be effective without anti-retroviral therapy."
South Africa is one of the countries worst affected by HIV/AIDS, with one in every nine citizens infected by the virus.
According a UN estimate, some 360,000 people died of AIDS in 2001 -- nearly 1,000 per day.
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