Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
South African Press Association - November 29, 2005
Jacques Keet
The HIV/Aids pandemic is first among a number of factors standing in the way of realising child rights in South Africa, CI director Professor Marian Jacobs told journalists on Tuesday.
Speaking at the launch of the institute's annual publication on the situation of South Africa's children -- to coincide with World Aids Day on Thursday -- she said a comprehensive response to children infected and affected by the disease is necessary.
Medical Research Council (MRC) studies indicated that 40% of deaths of children under the age of five years are directly attributable to HIV/Aids.
"This means that HIV/Aids is the leading cause of deaths among children under five years of age -û nationally and across all provinces -û primarily due to HIV transmission before and during the birth process."
At the same time, diseases of poverty account for at least 30% of all under-five child deaths, Jacobs said.
The CI's publication, South African Child Gauge, is the first of its kind for the country, and is aimed at providing an annual reminder of the challenges South Africa still faces in promoting and protecting child rights.
Every year, it will present an analysis of legislative and policy developments related to children's rights, qualitative essays on a themed topic, and child-centred data on the realisation of children's socio-economic rights.
The fist edition focuses on the theme of children and HIV/Aids.
According to the document, the second major obstacle to the realisation of child rights is the income inequality and widespread poverty that continues in the country.
Statistics for 2004 show that almost 12-million children (66% of the child population) were living in poverty.
Jacobs said the fact that the unemployment rate is rising alongside the HIV infection rate is of great concern, because poverty deepens the effects of HIV/Aids on households, while the disease in turn aggravates already existing poverty.
"Given that HIV/Aids is compounding the general ill-health effects of poverty, it is important to reflect on the comprehensive health-care needs of children with HIV infection.
"A comprehensive health-care package can improve child health, prolong life and delay the need for anti-retrovirals," she said.
CI deputy director Dr Maylene Shung-King said the first priority -- and the most significant response -- is the prevention of childhood HIV infection.
"Around the world, almost two-thirds of new infections that occur in children are through mother-to-child transmission.
"It therefore makes sense to target mother-to-child transmission as the first area of prevention.
"In this regard, there is an urgent need for a focused drive to help pregnant women counter the fear of stigma to encourage voluntary counselling and testing, and to emphasise the benefits of prevention of mother-to-child transmission to the next generation, while improvements to health-service delivery should also be prioritised."
The CI analysis of the government's plan on the care, management and treatment of HIV/Aids indicates it does not adequately address two key interventions -- reducing HIV infection in adults and the prevention of mother-to-child transmission.
"Both these interventions would have the greatest effect on reducing HIV in children," Shung-King said.
Other issues related to children and HIV/Aids in the publication include the need for appropriate social security to children affected by HIV/Aids, the use of schools as nodes of care and support to identify and support children most in need, and the importance of children's participation in decisions that affect their lives, particularly in the context of poverty and HIV/Aids.
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