LONDON, 9 February 2006 (RFE/RL) -- Children infected by HIV/AIDS and those orphaned following the deaths of their sick parents need urgent and sustained international help. As the delegates from some 90 international organizations, NGOs, and governments concluded at this year's Global Partners Forum in London today, the situation demands a practical and coordinated response.
Dr. Ann Veneman, executive director of UNICEF, told RFE/RL that the global response should be developed at both the UN and governmental level and at the local community and voluntary level. It is all about utilizing resources, she said.
"How do you marry those kinds of things that are going on, so that you're utilizing the resources?" she asked. "And there are a lot of resources coming in to help address the AIDS pandemic, but how can you make sure that they’re most effectively used?"
Veneman also points out that more than 2 million children under the age of 15 are living with HIV, and some 15 million have lost one or both parents to AIDS. More than 12 million of this total are in sub-Saharan Africa, where the situation is most tragic. In sub-Saharan countries there were 7.7 million children who had lost both parents in 2003, while in Asia, with four times as many children, there were 7.9 million.
Apart from Africa, most worrying developments, as far as HIV/AIDS are concerned, are taking place in Eastern Europe and the former Soviet republics.
"Eastern Europe and Central Asia have the fastest-growing HIV epidemic in the history of AIDS," UNAIDS Executive Director Dr. Peter Piot said. "Take the Russian Federation, already 1 million living with HIV; Ukraine has a high HIV prevalence -- well over 1 percent of the adult population -- and it's spreading.”
Piot noted that what makes the situation unique in the world is that drug use, heroin in particular, is a major factor, especially among young people. Increasingly, so is sexual transmission.
"It is also having an impact on children, of course," Piot said. "I’ve seen it myself. During visits, frequent visits in the region, we start seeing orphans because they lost their parents because of AIDS [and] children who are ill with AIDS and who need treatment."
Piot also said that there are also some positive developments, with programs to prevent transmission from mother to child taking hold in a number of countries in the region, such as Ukraine. However, he said that more grassroots activity by the people in the community is needed.
"Whenever I visit one of the countries in the region, what is striking to me is that people still expect basically everything from the state," he noted.
Piot concluded that this lack of grassroots action understandingly has historical roots, as the communist regime used to suppress all such activity, but also because the development of civil society is not always fully appreciated. So it is up to the people, and particularly the infected community, to get organized.
A 1,000 Percent Increase In Five Years
The London conference also invited delegates from the post-Soviet region to participate. A member of the Ukrainian delegation is professor Alla Shcherbinska, who heads the National AIDS Center in Kyiv. She confirmed Piot's assessment.
"There are HIV-infected children in our country too, but their number is small. However, the epidemic is growing in the whole world and it concerns Ukraine too, so we want to stand as a united world community and make use of the achievements of other countries in the fight against this disease," Shcherbinska said.
Also concerned about the pandemic spreading in the former Soviet Union is Dr. George Ionita, regional adviser of UNICEF. He agreed that the current trend is extremely worrying.
“[The increase has] been over 1,000 percent in the last five years, and at present approximately 1.4 million people are estimated to be living with HIV. That's 1.4 [million] out of the global 38 million, so that would represent an increasing share of the global number of people living with HIV," Ionita said.
Attacking The Young
Ionita said that the most concerning aspect of the situation is that 80 percent of those infected with HIV are under the age of 30. And a disproportional number of them are very young and are getting infected very quickly. Drugs play a major role.
"The predominant mode of transmission is injecting drug use, approximately 70 percent," he said. "But then you have the sexual transmission and an ever-increasing percentage from mothers to their children. For example, each day in the Russian Federation, 20 children are born to mothers living with HIV."
Ionita said there are also some success stories. For example, mother-to-child transmissions in Ukraine have gone from 27 percent to 12 percent in three years. He says there is a very long way to go, but in places there may be light at the end of the tunnel.
UNICEF's Veneman concludes that with less than 10 percent of the children who have been orphaned or incapacitated by AIDS getting any public support or services, the Global Partners Forum is recommending urgent improvements in four major areas of care:
- The capacity of families to protect and care for orphans and other children made vulnerable by HIV should be strengthened and community-based responses need mobilizing. The primary beneficiaries of an increased global AIDS response should be the families and communities.
- Equal and full access to education must be ensured to help raise awareness of HIV/AIDS and help children -- including girls -- to escape the poverty trap. One of the priorities in this area is the urgent removal of primary school tuition fees that apply in some developing countries.
- Universal access to HIV prevention, treatment and care must be guaranteed, so that by 2010 the spread of the disease among adolescents and from mothers to babies is halted.
The conference is also examining how to improve laws, so that legislative protection for vulnerable children is properly codified. And it has recommended improvements in birth and death registration, so that orphans can obtain official records making them eligible for food aid or free medical care.
The United Nations has issued its annual report on the AIDS epidemic. Here are some of its findings:
- There are currently an estimated 40.3 million people living with HIV, the virus that causes AIDS. Of those, 17.5 million are women and 2.3 million are children under the age of 15.
- There were an estimated 4.9 million new HIV infections in 2005, including 700,000 children under the age of 15.
- An estimated 3.1 million people, including 570,000 children, died of AIDS in 2005.
- According to the report, more than 25 million people have died of AIDS worldwide since the disease was recognized in 1981.
- In Eastern Europe and Central Asia, the number of HIV-positive people reached 1.6 million in 2005, up from 1.2 million in 2003. The bulk of people living with HIV in the region are in the Russian Federation and Ukraine. "Ukraine's epidemic continues to grow, with more new HIV infections occurring each year, while the Russian Federation has the biggest AIDS epidemic in all of Europe," the report states. A private Russian survey cited in the report found "no postive changes in sexual behaviour, with condom use decreasing slightly among people in their twenties."
- In Central Asia, Uzbekistan and Kazakhstan have seen the most dramatic increases of HIV infections. In the Caucasus, the situation is described "relatively stable."
Central Asia: AIDS Project Seeks To Avert Epidemic
Eastern Europe: European Commission Warns Of 'Resurgent' HIV/AIDS Epidemic
Listen to a short interview by RFE/RL's Tajik Service with Gregory Henning Mikkelsen, director of EU team for a joint EU/UN AIDS initiative. In the November 21, 2005, interview, Mikkelsen describes the epidemic in Central Asia.Real Audio Windows Media