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AIDS, Public Policy and Child Well-Being

The UNICEF Innocenti Research Centre published the findings of a global study carried out in 2000 on the specific impact of HIV-AIDS on children. The study is based on eight country case studies - five 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 study examines the damage caused by HIV-AIDS to the well-being of children and families and to the smooth functioning of the societies in which they live. 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. Studies and programmes on HIV-AIDS and children tend to concentrate on those directly affected by HIV-AIDS, such as AIDS orphans, HIV positive children and children of families with an infected adult. However, as this study shows, the disease devastates every part of society and its effects are felt by the vast majority of children, whether from HIV-AIDS affected families or not. Education systems, for example, 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. Another gap in the policy debate is on measures needed to ease the impact of HIV- AIDS on all children. The focus has been on information campaigns, the care of HIV positive adults and support to community-based responses for orphans. Affected communities have often carried out such programmes alone and unaided. 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 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; and accelerated recruitment, training and induction of key personnel such as teachers, doctors and administrators. Stronger budgetary support and international aid are needed for HIV- AIDS programmes, while government support to vulnerable families and to related areas should also be strengthened.