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Mercy Global Concern - 2003
Children under Siege from HIV/AIDS
" Fifty per cent of the new infections (HIV/AIDS) which take place today
are in the 15 to 25 age group. I mean if we are the future and we are dying,
there is no future." - Mary Phiri, editor of Trendsetters, an HIV/AIDS news
monthly produced by teenagers in Zambia
Over the past five years, HIV/AIDS has changed the landscape of the world more
than any other factor. Worldwide, HIV/AIDS has killed 3.8 million children and
orphaned 13 million more. In many part of Africa, HIV/AIDS is now the main threat
to human survival - 18.8 million people have already died of HIV/AIDS and the
projections in the worst affected countries, estimate that up to half of all
today's 15 year-olds will die from the disease.
UNIFEM and UNICEF in their publication 'War-Affected Children', suggest that
the chaotic and brutal circumstances of war aggravate all the factors that fuel
the HIV/AIDS crisis. War breaks up families and communities, creating millions
of refugees and placing women and children in great peril of sexual attack or
systematic rape used to terrorize opposing forces. It destroys the health service
that might have been able to identify the diseases associated with HIV/AIDS
or screen the blood transfusions that might transmit it. War destroys the education
system that might have been able to teach prevention and slow the spread of
the disease. AIDS contributes to political instability by leaving millions of
children orphaned and by killing teachers, health workers and other public servants.
About half of the people with HIV/AIDS become infected by 25 and are likely
to die with AIDS by the age of 35, leaving their children to be raised by grandparents
or fend for themselves in child-headed households. More than 10 million people
living with HIV/AIDS today are between 10 and 24 years of age. At least 50 per
cent of all new infections occur in the 10-24 age group, with 7000 new infections
every day. Although Adolescents have the highest rates of HIV/AIDS, they also
represent a huge asset when it comes to rebuilding communities. Armed with abundant
resilience and learning capacities, they are an invaluable resource, particularly
as communicators, information carriers and counselors for other the wider community.
Over 90 percent of all HIV/AIDS-infected children under the age of 15 started
life as babies born to HIV-positive mothers. Recent studies indicate that the
administration of anti-retroviral drugs can reduce HIV transmission at birth,
but without access to these drugs, or other interventions around one in three
HIV-positive pregnant women will pass the infection on during pregnancy, at
birth or through breastfeeding. Yet women have no choice but to breastfeed.
In refugee camps, there is little or no access to safe water, let alone formula,
or the money to buy it with. Indeed, breastfeeding is likely to be the safest
method of infant feeding. This speaks to the urgent need for women to have access
to testing, counselling and anti-retroviral drugs. But that access does not
exist for populations in developing countries even during times of peace. The
failure to provide that minimum assistance underlines the obstacles that must
be overcome in order to reach the populations in conflict.
Programming to prevent and treat HIV/AIDS must be vigorously pursued at the
national and local level. In the absence of functioning health and education
systems in conflict situations, humanitarian agencies and the NGOs have provided
health services for displaced populations who would otherwise be unreachable.
All humanitarian responses in conflict situations should ensure, within the
mainstream of health care, free voluntary and confidential counselling and testing
for HIV/AIDS, proper screening of blood, and medical supplies to deal with the
opportunistic infections that accompany HIV/AIDS. These services must be available
throughout the whole population to avoid inadvertently creating a double standard.
No matter how difficult the circumstances, HIV/AIDS must be confronted vigorously
and resolutely. So far the response has been tragically inadequate. In 1998,
donor countries on the fight against HIV/AIDS spent only $300 million. An estimated
$3 billion is needed, i.e. $1.5 billion for prevention activities and $1.5 billion
for basic care, excluding anti-retroviral drugs. Currently, no country in Africa
spends more than 1 per cent of its health budget on HIV/AIDS. Drug treatment
has become steadily more effective, but at present, only a tiny minority of
people in developing countries has any access to such treatments.
The International community has begun to unify its efforts in the fight against
HIV/AIDS. In July 2000, the Security Council recognized the threat of the AIDS
pandemic and called for strategies to prevent the possible spread of HIV/AIDS
through peacekeeping forces. In addition, the International Partnership Against
AIDS in Africa (IPAA), a collaboration among African governments, international
donors, United Nations agencies, civil society and the private sector, was formed
in 1999 to consolidate strategies and resource mobilization for the fight against
AIDS in Africa. It has called for increased support for fragile government structures
in conflict-affected countries, to develop comprehensive national AIDS programmes.
Within the United Nations, an Interagency Standing Committee (IASC) subgroup
on HIV/AIDS in complex emergencies was formed to draft policy and coordinate
programmes in response to the HIV/AIDS pandemic in war-torn countries.
At the International Aids conference held in Durban, South Africa, former-President
Nelson Mandela issues a challenge and a word of encouragement to governments,
communities, agencies and NGOs: "Stigma and discrimination can be stopped, new
infections can be prevented and the capacity of families and communities to
care for people living with HIV/AIDS can be enhanced. The challenge is to move
from rhetoric to action, and action at an unprecedented intensity and scale."
Recommendations:
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In the belief that care and services must be made available
to all populations affected by AIDS, in peacetime and during war, governments,
humanitarian and development agencies and NGOs are called upon to re-frame
their work and increase technical support and resources so that improved
treatment, care and support is available for children, affected by HIV/AIDS
in conflict and in neighbouring communities.
- Schools and education systems must be the centerpiece for HIV/AIDS awareness,
prevention and care during emergencies, including expanded life skills curricula
that offer nutritional support, hygiene and other domestic survival skills.
- Education and training on HIV/AIDS prevention should be mandatory for all
military and peacekeeping personnel, together with voluntary and confidential
counselling, testing and treatment. Codes of conduct should be strictly enforced
through disciplinary action, which can help lessen the incidence of sexual
violence.
- More resources should be allocated to assess, including through data analysis,
the links between AIDS, conflict and children, with particular reference to
girls, and the gender dimensions of conflict and the pandemic.
Deirdre Mullan RSM
Director
Mercy Global Concern
Representing the Sisters of Mercy at the UN
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