AIDS and Children: The Best Way to Help is to Keep Their Parents Alive

Editors note: Op-Ed by William Fleming, as it ran in the Dec. 7th edition of the Raleigh, North Carolina News & Observer

During a recent trip to India I met with a group of 30 adults living with HIV. We sat in a circle discussing the challenges they face living with the disease in rural India.

As we talked, many of the adults briefly diverted their attention to care for their young, squirming children. It is their children who are their main focus in the fight against HIV/AIDS.

Asked how many of the adults are taking anti-retroviral drugs, nearly two-thirds raised their hands, a testimony to India's efforts to expand treatment and care services into the rural areas. However, when I asked about the adults' greatest needs, there was no mention of drugs or treatments.

Again and again they voiced concerns for their children. They wanted to know, "What will happen to them when we grow sick or die?"

These parents understand very well the increasing risks -- both health and non-health-related -- facing their children.

More than 15 million children have lost one or both parents to AIDS, and millions more have been made vulnerable. The number of orphans created by the disease is expected to increase globally through 2025, representing a second wave of the epidemic.

As households cope with caring for a sick family member, children often bear the brunt of rapidly dwindling resources in the form of withdrawal from school, less to eat and often exploitative and dangerous work to help support their families. Suddenly the children find themselves thrust into the parent role, creating child-headed households. It is a battle we have only begun to fight.

And while some children are orphaned by AIDS, millions are fighting the disease themselves. The U.N.'s recently released 2007 AIDS Epidemic Update highlights some important gains for children. Although the total number of children living with HIV has increased from 1.5 million in 2001 to 2.5 million in 2007, the number of new infections in 2007 dropped from 460,000 in 2001 to 420,000. Deaths among children have also begun to decline after peaking in 2005. These are important signs of progress, but they are small steps and only mask a much larger epidemic.

ACROSS AFRICA, CCF IS WORKING WITH YOUTH as key partners in the response to the AIDS epidemic. In Kenya, youth tutors provide support and mentorship to vulnerable children struggling to stay in school while coping with loss and illness in the home. Youth in Zambia are managing an Internet cafe that provides information on AIDS and sexually transmitted infections as well as referrals to youth-friendly health services. Networks of youth centers in Uganda implement action plans that include AIDS prevention and economic development activities. Christian Children's Fund's partnership with youth reflects our respect for the right of all individuals to participate in their own development.

We need to commit ourselves to meeting the challenge of caring for children affected by AIDS. To do this, we need to rapidly scale up care and treatment for people living with HIV, with an emphasis on prevention of parent-to-child transmission and care for women living with HIV. Parents provide the best care and protection for their children, and keeping parents alive is the best solution. For orphans and children living with infected parents, programs promoting high-quality education, primary health care and nutrition, as well as social inclusion and emotional care for children, are all critical elements of an effective response.

The women and men in rural India are benefiting from expanded care and treatment services but are living examples of the challenges that remain. Their concern should be our concern. HIV/AIDS can't be fought with drugs and treatment alone. Together with these courageous parents, we need to provide an answer for their concerns. We must care for the children.

The good news is we are making progress, but this is no time to let up. The lives of millions of children hang in the balance.
William Fleming, who grew up in Raleigh and graduated from UNC-Chapel Hill, has worked on HIV/AIDS and health programs for more than 10 years. He is now the CCF's HIV/AIDS program specialist.