Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
South African Press Association - August 15, 2006
Fran Blandy
"When it comes to children the world has failed dismally," Michael Sidibe, director of country and regional support of the United Nations Joint Programme on HIV/Aids (UNAids), told the International Aids Conference at the release of the report.
An estimated 380 000 children under 15 died of Aids-related causes in 2005 and 16% of orphans are under five years old, read the report by the UN Children's Fund (Unicef), UNAids and the United States President's Emergency Plan for Aids Relief (Pepfar).
"Despite a massive international response to HIV/Aids, and the many successes helping adults with the disease, there remains a missing face to the agenda," said Sidibe.
The Aids epidemic affects children in many ways. They often take on extra burdens when living with a very ill parent, and can suffer discrimination.
Sub-Saharan Africa is home to 80% of all children worldwide who have lost a parent to the disease.
The report shows that even where HIV prevalence begins to decline, the number of orphans will continue to grow and stay high for years.
Mary Mahy, of Unicef, said 16 countries in sub-Saharan Africa currently have national plans of action to help orphans and vulnerable children. She added that there needs to be "rigorous and strong" research.
According to the report, extended families usually take on orphans and vulnerable children in Africa. However, places with advanced epidemics see children ending up in poorer households and available caretakers becoming "scarcer and more impoverished".
Kent Hill, assistant administrator from the bureau of global health with USAid, said it is vital to appreciate that not enough is known about how communities are dealing with this issue. Often those made vulnerable by being orphaned are at a greater danger of becoming infected themselves.
"The best thing is to make sure they are not orphaned in the first place," he said.
Kenya is one country that says it is providing care for this sector of the population. The director of the Department of Children's Service, Ahmed Hussein, said 9 500 families caring for orphaned children currently receive about $14 (about R95) a month on condition that the children have access to education, health care and birth registration.
New regulations for adoption have been made, as well as regulations for institutions caring for orphans, to ensure their best interests are looked after. A campaign has also been launched on violence against children.
"The missing face of children in the pandemic refers to not only those who are infected, but also those that are affected," said Hussein.
However, for those that are infected, there is a dearth of paediatric formulations and treatment.
According to a M decins sans Fronti res (MSF) fact sheet, a child under the age of 15 is infected with HIV every minute.
"Treatment must include drugs for opportunistic infections and for co-infections. In the hardest-hit areas, pregnant women have inadequate antenatal care.
Said Louise Binder of the Canadian Treatment Action Council: "We would have far fewer orphans to care for if we looked after mothers properly."
An MSF staffer, Fasineh Samura, who works in Malawi, said physicians often hesitate before treating children. "We are still waiting for simple guidelines or standardising dosing charts to help doctors provide the correct dosages," she said.
Treating a child could be up to four times more expensive than treating an adult. For children who cannot swallow a pill, the syrups or powders that need to be mixed with water often do not suit rural settings.
"Some syrups must be refrigerated after opening, implying reliable electricity supply in patients' homes," said MSF.
The Unicef report says the problems facing children in sub-Saharan Africa can be addressed by providing support, as well as having sufficient knowledge to understand the situations of these children.
"Rapidly accelerated and adequately resourced action can help ensure that orphans and vulnerable children grow up safe, healthy, happy and well-educated," reads the report.
060815
SA060807
Copyright © 2006 - South African Press Association. Reproduction of this article (other than one copy for personal reference) must be cleared through the South African Press Association, Cotswold House, Greenacres Office Park, Cnr. Victory & Rustenburg Roads, VICTORY PARK, PO BOX 7766, JOHANNESBURG, 2000; Fax No: +27 11 782-1587/8, Tel No: +27 11 782-1600.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.
Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .