A report released June 27. 1997 by the joint United Nations Programme on HIV/AIDS (UNAIDS) documents the Increasingly dramatic situation of millions of children worldwide who are living under threat from the HIV/AIDS,epidemic. Every day. 1,000 children become infected with HIV. UNAIDS estimates that, by the end of 1997, I million children under the age of 15 will be living with the virus and suffering the physical and psychological consequences of infection. Since the beginning of the epidemic. well over 2 million HIVpositive children have been born to HIV-positive mothers and hundreds of thousands of children have acquired HIV from blood transfusions and through sex or drug use. Over 9 million children are estimated to have lost their mothers to AIDS.

"AIDS is the most recognised disease in the world today," said Dr Peter Plot, the Executive Director of UNAIDS in launching the campaign, "but the disastrous impact it is having on children has not been given enough attention. If the spread of HIV is not rapidly contained, the gains made in reducing itt-fant and child death rates, will: । be reversed in many countries." Estimates quoted in the report indicate that, by the year 2010. AIDS may increase infant mortality by as much as 75 per cent and under-five child mortality by more than 100 per cent, in the most hard-hit countries in the world.

"Within a little more than a decade. AIDS will be a major cause of death among children", stresses Carol Bellamy. Executive Director of UNICEF. "But children do not have to contract HIV to be profoundly harmed by it. The number of orphans are growing dramatically, children are traumatised by watching parents, die. forced out of school to take the place of adults at home, and often suffer from discrimination. HIV has become a real threat to children’s rights."

The report, entitled "Children Living in a World with AIDS", is released to mark the launch in Brussels of the 1997 World AIDS Campaign which aims to Increase public understanding of the devastating Impact of HIV/AIDS on children

and to promote further action to prevent HIV infection and improve care. The Campaign is being led by UNAIDS and its cosponsoring organisations — UNICEF, UNDP. UNFPA. UNESCO. WHO and the World Bank — in partnership with the Francois-Xavier Bagnoud Centre for Health and Human Rights of the Harvard School of Public Health, the Children and AIDS International NGO Network, the NGO Group for the Convention on the Rights of the Child, and the development information agency. PANOS.

Children Living with HIV

According to the report.

are contracting HIV and there is no sign that the Infection rate is slowing. In 1996 alone 400.000 children under the age of 15 years became infected worldwide. Around 90 per cent of these children acquire the virus from their HIV-positive mothers. whether before or during birth or through breastfeeding. And women ofchlldbearing age are now making up an ever-increasing proportion of people with HIV worldwide: today. AIDS kills more women than men in sub-Saharan Africa.

In the lohger.term. therefore, reducing the-vtkneraMflty of infants to HIV Infection means increasing women's control over their situations, improving their ability to take decisions about their own reproductive and sexual health, and increasing the knowledge and sense of responsibility of both men and women about HIV prevention. It also means increasing women's access to antiviral drug regimens which can cut the risk of mother-to-child transmission.

For children who are already infected and sick, the report shows that the situation remains very grave. This is particularly so in many poorer countries, which have been unable to benefit from the recent advances made in antiviral therapy, and where even inexpensive medicines to treat HIV-related illnesses and reduce suffering are often unavailable. In Europe, more than 20 per cent of HIV-positive children are still alive at the ago of 10. In Zambia. In contrast, a recent study showed that nearly 50 per cent of HIV-positive children

had died by the age of two.

Children Orphaned by AIDS: An Exploding

Problem

Children are not only infected by HIV, they are also affected. More than 90 per cent of the 9 million children who are currently estimated to have lost their mothers to AIDS live in sub-Saharan Africa. Experts in Zimbabwe, for example, estimate that by 1996 approximately 8 per cent of children in the country were in this situation. In Uganda. 1.000 children every week lose one of their parents to AIDS.

Children living in communities struck by AIDS feel Its impact as their parents and teachers become infected, as health and social services are stretched beyond their limits, and as their families also take in other children who have been orphaned by the epidemic. Says Elizabeth Mataka. Executive Director of Family Health Trust in Zambia, "In some of the worst-hit African communities. there are only children and old people — the age groups in between have been almost wiped out. No one yet knows what effect (his will have on.the ■ children and their future/ In ' all countries! families, and the traditional safety net of the extended family, are coming under increasing pressure — a recent survey of social care in seven countries participating in the European Collaborative Study showed that, by age 8. 60 Bsr cent of children born to

IV-positive mothers lived in alternative care.

When an HIV diagnosis occurs in the family, the household often also suffers disproportionately from stigma, isolation ana impoverishment, the report notes. A recent study in Thailand found that many parents had lost Jobs as a result of AIDS and that stigmatisation. due largely to incorrect beliefs about HIV transmission, was widespread. "Despite the almost universal ratification of the UN Convention on the Rights of the Child, in many countries children are still suffering from gross discrimination and exploitation as a result of their HIV status or that of members of their families", said Peter Plot. "Children have

a right to be better informed and better protected."

Living in the Shadow of

HIV Risk

No one knows how many child sex workers here are in the world but recent figures indicate that more than I million children enter the sex trade every year. The HIV/AIDS epidemic has made child sexual abuse and child prostitution more dangerous than ever and the belief that children are less likely to be Infected has raised the demand for younger sex workers.

Awareness is also growing of the scale of child abuse that takes place in or near the home. A study of children under 12 being treated for a sexually transmitted disease at a clinic in Zimbabwe showed that the majority had been abused and infected by neighbours or close relatives, the report states.

A Window of Hope

But if children are an increasing part of the AIDS prob- _ lem, they are also a critical part of the solution. Information and the promotion of children's rights are important keys to reducing risk frehavibtif/SMdBfii Roedy Pfesidentof' MTv'Ntt-wbrks International. There i?-an essential need to communicate with young people in a manner which they will understand. appreciate and relate to. HIV and AIDS demand that we talk about some pretty tricky subjects — but I can see no reason for preventing potentially life-saving information from reaching those with most to lose."

The report recommends a number of areas in which sustained efforts can improve the situation for children, including providing sexual health education; expanding both educational and employment opportunities; and strengthening health and social services to families and communities.

"AIDS has changed the world for children." said Dr Plot. "It is the responsibility of everyone — governments, communities and individuals — to rise to this new challenge and to bring urgent support to children and tneir families as they face the uniquely painful realities of life in a world with AIDS."