AIDS, public policy and child well-being

This paper presents the findings of a global study carried out in 2000 on the specific impact of HIV/AIDS on children. The study is based on nine country case studies - six in Africa and three in Asia - and a review of five key areas: the health sector, the education sector, access to antiretroviral drugs, economic impact and child impoverishment and orphanhood.

The author argues that while the health challenges posed by HIV/AIDS are widely recognized, the specific impact of HIV/AIDS on children remains poorly documented, analysed and addressed. Much debate has focused on adult prevalence and death rates and on ways to control the epidemic in the short-term. This study calls for a new focus on the wider impact of HIV/AIDS on children's lives, including falling school enrolment, increased malnutrition and rising poverty.

The paper states that the narrow focus on children directly affected by HIV/AIDS is ineffective and that wider issues must be considered, such as the effects on education systems, which are weakened by mounting AIDS mortality among education personnel. Other ripple effects include health services that are overwhelmed by HIV/AIDS, declining food consumption among the children of families who take in AIDS orphans, and general impoverishment due to economic slowdown.

The study calls for broader insurance and redistributive policies, including income transfers from central government and the international community. It also calls for public policies that are wider in scope, more pro-active and that take a long-term approach. Programmes that it argues should be prioritized include:

• strengthening of primary health care
• rapid expansion of programmes to prevent mother-to-child transmission
• gradual expansion of adult treatment with generic antiretrovirals
• accelerated recruitment, training and induction of key personnel such as teachers, doctors and administrators

[adapted from author]