This is an archived USAID document retained on this web site as a matter of public record.
Administrator J. Brian Atwood
World AIDS Day and the release of Children on the Brink: Strategies to Support a
Generation Isolated by HIV/AIDS Report
Washington, D.C., December 1, 1997
U.S. Agency for International Development
I would like to thank Carol Bellamy, Dr. Piot and
the others who worked with us to make this event
today possible. As some of you know, for four
years I have advocated development assistance as
an essential element of crisis prevention. This is
why I am so deeply troubled by the findings of the
report that USAID is releasing today: Children on
the Brink. It is my belief that the findings in this
report must serve as a powerful wake up call
alerting us all to a crisis of terrible magnitude.
According to our study -- which looked at 23
countries -- the total number of children who will
lose one or both of their parents from all causes in
these 23 countries is projected to increase from
34.7 million in 2000 to 41.6 million in 2010.
The human and social costs of these numbers are
mind-boggling. In countries across Africa, Asia
and Latin America, HIV/AIDS is rapidly reversing
years of hard won progress in economic and social
development. Life expectancy -- which has been
steadily on the rise for the last three decades --
will drop to 40 years or less in nine sub-Saharan
countries by the year 2010. In countries like Botswana, Zambia, and
Zimbabwe, which would have had life
expectancies of 60-70 years without HIV/AIDS,
we will see life expectancies plummet to around 30
years with HIV/AIDS. We live in a world so
technologically sophisticated, so closely
interconnected, and yet in parts of the world we
are seeing life expectancies that will drop to
medieval levels.
In all the countries included in this study, AIDS-related mortality will eliminate the gains made in
child survival over the past 20 years. In Zambia
and Zimbabwe, infant mortality rates will likely
nearly double, and child mortality rates will triple.
In many of the sub-Saharan African countries
included in this study, the HIV/AIDs epidemic is
severe, with the percentage of the population
infected with HIV reaching more than 30 percent
in some urban areas.
However, the countries that are most seriously
affected by HIV/AIDS are in Asia and they are
home to over 20 percent of the world's population.
By 2020 the largest number of children to lose
parents to HIV/AIDS will likely be in South and
Southeast Asia. The sheer size of the population at
risk for HIV/AIDS in Asia means that the problem
of parental deaths there will eventually eclipse that
of sub-Saharan Africa. The number of children
likely to lose their parents due to HIV/AIDS will
also continue to grow in Latin America and the
Caribbean, where the epidemic also started later.
The growing number of children who will lose
parents will have a profound impact on these
societies. The economies of the developing nations
in this study will all struggle to deal with the
immense economic dislocation and costs of illness,
death and lost opportunity.
With children who have lost parents eventually
comprising up to a third of the population under
age 15 in some countries, this outgrowth of the
HIV/AIDS epidemic will create a lost generation --
a sea of youth who are disadvantaged, vulnerable,
undereducated and lacking both hope and
opportunity. What we are seeing here are the
seeds of crisis. These are the numbers that should
make us all take a long hard look at what kind of
world we are going to be living in fifteen years
down the road.
The creation of such a large and disaffected
demographic "youth explosion" could propel some
of these societies to significant unrest and
destabilization over the long term. The threat to
the prospects for economic growth and
development in the most seriously affected
countries is considerable. New approaches --
including policy innovations for women and
children -- must be developed within the next few
years to nurture and develop local efforts to assist
families and communities affected by the crisis.
But even more important than the numbers
contained in this study is the human story they tell.
Children's are left emotionally and physically
vulnerable by the illness or death of one or both
parents. In countries with even only moderately
severe HIV-infection rates, up to 25 percent of
children born to healthy women may have at least
one HIV-infected parent by their fifth birthday.
Subsequently, children who have lost parents are
more likely to be removed from school because
their households need new sources of income and
labor. Children are increasingly forced to assume
adult roles in the home and the workplace. Strains
on households and families may result in increases
in child abuse and neglect. Girls may face pressure
to marry at younger ages.
HIV/AIDS also causes the dissolution of families.
Children may be fostered or adopted prior to the
death of a parent. Orphans are cared for by
grandparents, uncles, aunts, or siblings. Female
orphans may be preferred for adoption over male
orphans because they can provide domestic labor,
sexual diversion, and, in many places, a bride
price.
In short, forty million children losing one or both
of their parents are 40 million children more likely
to be forced into child labor; 40 million children
who may never have an opportunity to attend
school; and 40 million children more at risk of
contracting HIV themselves.
It is impossible to overemphasize or exaggerate the
scope and complexity of challenges faced by
children affected by HIV/AIDS and by the
families, communities, and governments
responsible for them. The international community
-- through a host of concerned partners -- are
working to prevent new HIV infections and deal
with the immense problem of children who have
lost parents to AIDS.
The first and most important responses to the
problems caused by AIDS comes from the affected
children, families and communities themselves.
Arranging access to credit or ways to generate
additional income can help families overcome the
economic setback of illness and death. Reducing
"property grabbing" by protecting women's and
children's property and inheritance rights is vital.
Measures should also be taken to reduce the health
risks to children in households affected by
HIV/AIDS. These may include developing home-based health services, supporting child nutrition
programs, making special efforts to include these
children in immunization programs and other
health outreach efforts and targeting especially
vulnerable children.
Many of the communities hardest hit by
HIV/AIDS have fashioned similar responses to
HIV/AIDs and the needs of families and children.
We need to find new ways to strengthen these
community responses.
Developing country government leadership is also
needed to encourage all elements of society to
collaborate in developing realistic strategies to
meet the needs of children and families affected by
HIV/AIDS. All parties must work together toward
the overarching goal of creating an enabling
environment for those affected. Stigma and
discrimination impede efforts to prevent the spread
of HIV/AIDS and improve care and support of
those with HIV/AIDS.
Lastly, we must continue to support AIDS
prevention programs. Prevention is a question of
awareness, education and resources. Without more
effective prevention programs, the international
community will never get the upper hand in the
battle to protect children and families from the
impact of HIV/AIDS. USAID works with more than 500 private
voluntary and nongovernmental organizations in 40
countries to implement HIV prevention programs.
The agency has reached more than 15 million
people with comprehensive HIV prevention
education. Given the threat the epidemic poses to
sustainable development, USAID has made
reducing transmission of HIV and other sexually
transmitted diseases one of its strategic objectives.
We must all work together to save the next
generation of children, there is no other acceptable
choice. Thank you.
This is an archived USAID document retained on this web site as a matter of public record.
 |
Last Updated on: July 18, 2001
|
:
:
:
:
:
:
:
:
:
:
