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November 12, 2002

AIDS: A Deathly, Deadly Silence

Each day, 8,500 children and young people around the world are infected with HIV and 2,500 women die from AIDS. 600 people are infected each day in Moçambique alone. IN 1998 alone, the number of women killed by HIV/AIDS was 900,000-more than 3 times the death toll in Bosnia.

In Africa, the social and economic devastation caused by HIV/AIDS in the last decade is greater than the combined destruction of the continent's wars: an estimated 200,000 Africans, most of them women and children, died as a result of conflicts in 1998 while 2 million people were killed by AIDS. The pandemic wipes out families, villages, professions, and age groups. From country to country, it has marched through sub-Saharan Africa where 22.5 million people now live with HIV. Early in its assault the disease cut down the educated: professionals, administrators, teachers. Today, in sub-Saharan Africa, as all over the world, HIV/AIDS preys on the young, poor, and powerless- girls and women in particular.

While the educated have access to the knowledge needed to protect themselves from the virus, the life-saving information is not finding its way to those with little or no education. According to a study of 35 countries, the uneducated, whether men or women, were 5 times more likely to know nothing about the disease than were those with post-primary schooling. The uneducated were four times more likely to believe that there is no way to avoid AIDS, three times more likely not to be aware that the virus can be transmitted from mother to child and three to four times more likely not to know that HIV-positive persons might look quite healthy.

Any visitor to villages where AIDS has been an aggressive invader finds a legacy of huts deserted, fields fallow, children stunned and orphaned. Equally haunting are the trauma and the long-term devastation. Parents fall ill and waste away, children are often forced to drop out of school to care for their dying parents and then their orphaned siblings. Often, they lose claim to their parents´ property and are shunned and ostracized by the community. Nearly 10 million of these children under the age of 15 live in Africa today, their childhood forsaken and their rights to be nurtured in a family, to grow, to study and to develop to their full human potential denied them.

At times, the impact of the HIV/AIDS pandemic on children and women in this hardest hit of continents is difficult to grasp. In many countries, overall life expectancy is declining to levels last know in 1960, and even earlier. Of the nine countries with the highest HIV prevalence, Botswana, Namibia, and Zimbabwe are the most affected. Botswana, which had consistently allocated resources to basic services over the years, seemed poised for a public health breakthrough: It has been projected, in the absence of AIDS, that life expectancy would exceed the age of 69 by 2000-2005. Now, life expectancy is predicted instead to plumb new depths to 41 years in the same period.

Around the globe, AIDS is tightening the web of poverty and chronic insecurity in many societies, especially those burdened by heavy national debt. The stress on their limited social services is unbearable. Food production declines, leading to poorer nutrition and more vulnerability to illness. Lower education budgets mean less schooling for boys and girls, who later are less able to defend themselves against violence and abuse.


The world has little valid excuse for not embarking on a strategy that is know to stop the spread of the AIDS virus: relevant information that is readily available, educational and health services that are accessible and cater to adolescents, and the direct involvement of young people in their own health, development and protection. Nor has the world an excuse for failing to undertake the specific actions recognized as crucial: teaching prevention to young people and teaching mothers how to reduce mother-to-child transmission, providing care and support to orphans and children affected by HIV/AIDS, and providing care and support to those AIDS workers and volunteers who themselves are HIV positive.

Tragically, there is no indication that the resources needed will be forthcoming. If the international funds for poverty reduction have been a disgrace over this decade, the outlays to fight the global HIV/AIDS pandemic are an outrage. In 1996 and 1997, donor nations gave an estimated $350 million each year to combat HIV/AIDS. In comparison, during the Asian financial crisis, IMF, the World Bank, and rich countries gave $60 billion to bale out the Republic of Korea. And in 1999, the cost of NATO´s military operation in Kosovo and the rebuilding of the shattered country of Yugoslavia is an estimated $40 billion and growing.

International and national leaders faltered when they did not respond as swiftly and forcefully to the HIV/AIDS crisis in Africa as they could have 15 years ago. They now have a rare second chance to marshal their resources to block the ongoing spread in Africa and similar outbreaks in other regions of the globe. What was indefensible before would be unconscionable today.

From the UNICEF report on the State of the World's Children.