P07-UNICEF-ChildrenandAIDS by IDIA

The Institute for Domestic and International Affairs, Inc.

United Nations High Commission for Refugees Children Refugees Director: Natalie Rana

ÂŠ 2006 Institute for Domestic & International Affairs, Inc. (IDIA) This document is solely for use in preparation for Philadelphia Model United Nations 2007. Use for other purposes is not permitted without the express written consent of IDIA. For more information, please write us at idiainfo@idia.net

Introduction _________________________________________________________________ 1 Background _________________________________________________________________ 2 The Virus ________________________________________________________________________ 2 Recent History: Role of UNICEF ____________________________________________________ 5 The Forgotten Face of AIDS: Children________________________________________________________6 HIV and Young Women __________________________________________________________________8 Benefits of Education _____________________________________________________________________9

Current Status ______________________________________________________________ 11 Addressing HIV/AIDS in Africa in a Social Context____________________________________ 13 UNICEF Action__________________________________________________________________ 13 The Future of AIDS ______________________________________________________________ 14

Key Positions _______________________________________________________________ 16 Southern Africa__________________________________________________________________ 16 East, West, and Central Africa _____________________________________________________________18

Developed Western States _________________________________________________________ 19 Latin America and the Carribbean__________________________________________________ 21 Asia____________________________________________________________________________ 21 Middle East _____________________________________________________________________ 22

Summary___________________________________________________________________ 24 Discussion Questions _________________________________________________________ 25 Works Cited ________________________________________________________________ 26

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Introduction â&#x20AC;&#x153;Imagine an African community with no mothers or fathers, just children and grandparents. Increasingly, people across Africa are not having to imagine such a world: they are living it, everyday.â&#x20AC;?1

Children are the forgotten faces of the HIV/AIDS

epidemic. The HIV virus is responisble for disabling the development of Africa by hitting at the heart of communities: the young and productive members of society. As HIV hits societies, it endangers the physical, emotional and economic stability of children, who most often become the afterthought of the pandemic.

Children are

deprived of basic services, healthcare, and education, since the virus affects all parts of society from family members to doctors.2 Children are often required to take care of HIV infected parents or siblings, resulting in the deprivation of basic education, disabling these children from extending beyond poverty. Additionally, children orphaned from the death of HIV infected family members are forced to fend for themselves, creating a local and state level economic crisis. In order to make enough money to survive, orphaned children resort to dangerous and potentially risky activities, including involvement in the sex industry. HIV/AIDS creates a burden on the children who represent the future of African states. While politicians and leaders from the international community are committed to combating this virus through increased access to resources and materials, children are still missing out.3 Studies from the last twenty years consistently report that only 10 per cent of pregnant women have access to and information on services to prevent mother-tochild transmission of HIV/AIDS. Additionally, only 10 per cent of infected children receive social support or assistance.4 With the urgency in addressing the poverty situation in Africa, HIV/AIDS is an integral aspect in securing the future of the continent. Without the emergence of a 1

Olusoji Adeyi, Phyllis J. Kanki, Oluwole Odutolu, and John A Idoko, ed. AIDS in Nigeria: A Nation on the Threshold (Cambridge: Harvard University Press, 2006), back cover. 2 UNICEF, Children Affected by AIDS (New York: UNICEF publications, 2006), iv. 3 UNICEF, A Call for Action: Children- The Missing Face of AIDS (New York: UNICEF, 2005), 2. 4 A Call for Action: Children- The Missing Face of AIDS, 2.

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healthy and productive workforce out of today’s children, neither international aid nor funding will create sustained success.

By addressing every aspect of the plight of

children affected by HIV/AIDS, from infection to social and emotional effects, then Africa will be able to emerge with viable and sustainable solutions in development. The Millennium Development Goals hope to halt and reverse the spread of HIV/AIDS by 2015, but this is not achievable without providing feasible solutions in addressing this epidemic.

Solutions need to encompass the nurturing and protecting of future

generations of Africa from this virus to sustain development in the continent. Issues that need to be addressed include HIV/AIDS education and behavioral changes, finding efficient ways to halt the spread of the virus, developing new medicines and treatments, and getting international, state-level, and local cooperation in combating HIV/AIDS.5 While the international community continues to place emphasis on this issue through conferences, special meetings, and funding, feasible solutions need to be developed and implemented in order to reduce and prevent infection rates in the next ten, twenty-five and fifty years.

Background The Virus

Number of People Infected with HIV/AIDS

The Human Immunodeficiency Virus (HIV) was once concentrated in Sub-Saharan Africa, but has spread beyond borders to become the fourth most common cause of death worldwide.6 Since 1970, HIV has killed 23 million people, and the cumulative death toll is estimated to reach 45 million people by 2010.7

Source: http://news.bbc.co.uk/hi/english/static/ in_depth/africa/2000/aids_in_africa/default.stm

United Nations, The Impact of AIDS (New York: UN Publications, 2004), ix. UNICEF, “How Widespread is the HIV/AIDS Epidemic?”, < http://unicef.org/aids/index_epidemic.html> accessed 18 September, 2006. 7 UNICEF, “The Big Picture”, < http://unicef.org/aids/index_bigpicture.html?q=printme> accessed 18 September 2006. 6

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The fatal aspect of this virus slowly deteriorates the body’s defense system by damaging white blood cells that fight infection.8 According to the United Nations Children’s Fund (UNICEF), the HIV virus is contracted by “unprotected sex (intercourse without a condom), transfusions of unscreened blood, contaminated needles and syringes, and from an HIV-positive mother to her child during pregnancy, childbirth or breastfeeding.”9 A person who has contracted the HIV virus most often may not show signs of the virus for many years. An infected person can live healthily but can spread the virus through any of the aforementioned activities. While AIDS is not curable, it is a preventable virus. The best-proven method to lower the risk of HIV infection is abstinence from sex, and risks for sexually active people can be decreased by a reduction in the number of sexual partners and correct and consistent use of condoms. Common false misconceptions about the disease include that it can be contracted by touching, hugging, or shaking hands, or through toilet seats, utensils, linens, swimming pools, or mosquitoes. Contact with an infected person through these interactions cannot, in any way, transmit HIV.10 While it is an international issue, HIV is especially a problem in Africa as rapid infection rates result in a weak labor force, orphaned children and devastated communities. In states with ‘low or concentrated’ infection rates, the HIV epidemic is primarily spread through high-risk groups, including “males that have sex with males, people who inject drugs and those in the sex trade.”11 In the twelve Sub-Saharan states in Africa, 10 per cent of the population between 15 and 49 years of age is infected with HIV. Africa is categorized as a ‘generalized’ epidemic since the virus is not concentrated only within high-risk groups.12 Statistics illustrate a disturbing rate of HIV infections in Africa. Nine out of ten children with HIV are African children. This epidemic is a serious concern in Africa, as UNICEF predicts 60 per cent of 15-year-old boys in

UNICEF, “What is HIV/AIDS?”, < http://unicef.org/aids/23538_hivaids.html> accessed 18 September 2006. “What is HIV/AIDS?” 10 Ibid. 11 United Nations Children’s Fund, Joint United Nations Program on HIV/AIDS and World Health Organization, Young People and HIV/AIDS: Opportunity in Crisis (New York: UNICEF Publications, 2002), 9. 12 “How Wide Spread is the HIV/AIDS Epidemic?” 9

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Botswana, South Africa, and Zimbabwe will become infected with HIV within their lifetimes.13 The HIV/AIDS epidemic is a critical issue, however the affect that it has on youth is most important. The primary method of contracting HIV in Africa is through sexual activity, and surveys suggest that unmarried boys and girls, especially in Lesser Developed Countries (LDCs), are often sexually active before 15 years of age. Once adolescents begin having sex they are more likely to contract HIV/AIDS, since they are “likely to have sex with high risk partners or multiple partners, and are less likely to use condoms.”14 Additionally, early marriage, a common social practice in much of Africa, finds many girls married before eighteen years of age. According to UNICEF, statistics estimate that “children under 15 account for 1 in 6 global AIDS-related deaths and 1 in 7 new global HIV infections. A child under 15 dies of an AIDS-related illness every minute of every day, and a young person aged 15– 24 contracts HIV every 15 seconds.”15 AIDS kills 6,000 people in Africa on a daily basis. This staggering number is greater than the number of people that die each day from both war and natural disasters.16 Every year, some 800,000 new children in Africa are infected with HIV, and three million children live with AIDS today. Many more children are impacted by HIV/AIDS by the death of an infected family member; in subSaharan countries alone, almost four million children are orphaned by HIV/AIDS.17 The AIDS epidemic poses a serious threat to the development and progression of Africa. According to UNICEF, “HIV/AIDS has made hunger an even greater peril. An HIV-affected household can see its income drop by up to 80 per cent, and its food consumption by 15 to 30 per cent. One in four people in the productive age group (1513

Young People and HIV/AIDS: Opportunity in Crisis, 10. Ibid., 11. 15 “Why Children and Aids”, UNICEF, <http://unicef.org/uniteforchildren/knowmore/knowmore_28763.htm> accessed 17 September, 2006. 16 “BBC News/Africa/Aids,” BBC News, http://news.bbc.co.uk/hi/english/static/in_depth/africa/2000/aids_in_africa/default.stm> accessed 17 September, 2006. 17 “Southern Africa - Countries in crisis” UNICEF, <http://www.unicef.org/emerg/southernafrica/index.html> accessed 17, September, 2006. 14

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49) in this region are living with HIV.”18 HIV infections in both parents and young members of a family pave a path of devastation for families, as the loss of income forces younger children to bear the financial burden.19 Given such circumstances, AIDS creates a strain on the basic units of the society. Most often, women and children are burdened with the responsibility of supporting the family through any means possible, including prostitution and the selling of land.20

Recent History: Role of UNICEF UNICEF is the center of HIV/AIDS prevention programs for children and youth. Guided by the Convention on the Rights of the Child (CRC), UNICEF develops its HIV/AIDS campaign accordingly to achieve its goals. The CRC aims to “recognize that children have the right to develop physically, mentally, and socially to their fullest potential and to express opinions freely.”21 As the multi-faceted implications of the HIV/AIDS pandemic undermine many of the rights of children to develop, UNICEF places it as one of its top priorities, making it one of the most important United Nations agencies to combat HIV/AIDS. UNICEF works in collaboration with governments, nongovernmental organizations (NGOs), and religious groups to make this issue one of national priority in 155 states striken by this fatal virus.22 Combating HIV works towards achieving another Millenium Development Goal: education. As AIDS affects families and children, primary education, especially in Africa, is not prioritized. Long term effects of HIV/AIDS on societies include a decline in the social and economic development of a nation, which in turn leads to a decline in the quality of education that is offered.23 Once family members are infected with HIV, there is a decreased likelyhood of children remaining in school. UNICEF works with states to develop and implement national education programs to raise awareness about the 18

“Southern Africa - Countries in crisis”. Impact of AIDS, xi. 20 “Southern Africa - Countries in crisis”. 21 UNICEF, “UNICEF in Action”, <http://unicef.org/aids/index_action.html> accessed 18 September 2006 22 Ibid. 23 Impact of AIDS, xiii. 19

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disease and to keep children in school. Additionally, UNICEF takes a multi-pronged approach to fighting HIV through radio, television, and peer education initiatives.24 While education is one approach to combatting the virus, UNICEF also recognizes the impact of involvement of children in armed conflict.

Armed conflict, especially

prevalent in Africa in forms of civil wars and ethnic conflicts, is known to increase the spread of the disease. While UNICEF plays a critical role in the prevention of the spread of HIV, it works in collaboration with other UN agencies in accomplishing broader United Nations Millenium Development Goals of halting and reversing the spread of HIV/AIDS. UNICEF partners with UNAIDS, a joint program that combines the efforts of multiple UN agencies in accomplishing the UN Millenium Development Goals by 2015. UNAIDS leads these agencies in supporting nationally driven initiatives and responses to AIDS. This program works with governments, civil society, donors, and the private sector to combat HIV.25

The Forgotten Face of AIDS: Children UNICEF estimates that 6,000 young people, more than half of the newly infected HIV population, are between 15 and 24 years of age. Additionally, 11.8 million young people in this age group are living with HIV/AIDS.26 Young people face the greatest risk of contracting and spreading the HIV/AIDS epidemic.

The next generation of the

African workforce requires a nurtured and strong youth to work towards development of the continent. Carol Bellamy, the former Executive Director of UNICEF, asserts, “We cannot let another generation be devastated by AIDS.”27 UNICEF estimates that while more than 2 million children under fifteen years of age live with HIV, millions more live in AIDS-striken families and communities. Children affected by ill family members are often the most vulnerable targets of the virus, 24

“UNICEF in Action”. UNAIDS, “UNAIDS in Action”, <http://www.unaids.org/en/Coordination/default.asp> accessed 18 September 2006. 26 Young People and HIV/AIDS: Opportunity in Crisis, 5. 27 Ibid, 6. 25

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as they are pulled out of school, forced to work to bring in additional income, and required to take care of ill family members.28

Inevitably,

children

tending to ill family members lose parents and siblings to the virus and are left as orphans.

The AIDS

pandemic alone has created 15 million orphans by 2003.29

In Angola,

Lesotho, Malawi, Swaziland, Zambia, and Zimbabwe alone, there are four million children orphaned by AIDS. This statistic is expected to rise to beyond five million.30 The

significant

increase

children orphaned as a result of HIV places

significant

strain

communities and states. Orphans are often not able to financially support themselves, let alone other remaining

Source: http://unicef.org/publications/files/Girls_HIV _AIDS_and_Education_(English)_rev.pdf

siblings, resulting in hunger, malnutrition, and starvation.

In addition to the

consequences of droughts and low rainfall, HIV/AIDS lowers agricultural productivity and reduces food security.31 Sub-Saharan African data suggest that children between the ages of ten and fourteen orphaned by HIV/AIDS were less likely to be enrolled in school than children with at least one parent.32 28

UNICEF, Girls, HIV/AIDS and Education (New York, UNICEF publications, 2004), 2. Ibid, 2. 30 “Southern Africa – Countries in Crisis”. 31 Ibid. 32 Girls, HIV/AIDS and Education, 3. 29

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HIV and Young Women United Nations Secretary-General Kofi Annan stated “study after study has taught us

that there is no tool for development more effective than the education of girls. No other policy is as likely to raise economic productivity, lower infant and maternal mortality, or improve nutrition and promote health- including the prevention of HIV/AIDS.”33 Women make up of 58 per cent of HIV infected people in Sub-Saharan Africa, and are particularly vulnerable to HIV and are often unfortunate victims of sexual violence. Biologically, women are more succeptible to HIV. The likelihood of male-to-female transmission is twice than that of female-to-male transmission of the virus.34 The lack of education and knowledge about the HIV virus in women presents a formidable problem. More than 50 per cent of women between fifteen and nineteen years of age in heavily AIDS affected areas have not heard of AIDS or do not correctly know how the disease is transmitted.35 The positive coreelation between HIV/AIDS education and infection rates is illustrated by Ethopia, where four out of five educated women were able to identify that even healthy looking people could be HIV infected.36

In Africa, the disparity

between the education of men and women leaves women extremely succeptible to the virus. In AIDS-affected communities, women are left to fend for themselves after the death of the head of the household. In such situations, uneducated women may resort to trading sex for cash, food, and housing.37 Additionally, women are most often delegated the task of primary caregivers in AIDS-stricken families. In the face of taking care of an ill family, education is not a priority, thereby widening the education disparity between men and women. In Zimbabwe, the rate of young women taken out of school to take care

Ibid, 12. UNICEF, “The Female Face of AIDS”, < http://unicef.org/aids/23538_female_face_aids.html> accessed 18 September, 2006. 35 Ibid. 36 Girls, HIV/AIDS and Education, 13. 37 UNICEF, “How does HIV/AIDS affect Girls and Women?”, <http://unicef.org/aids/index_hivaids_girls_women.html> accessed 18 September, 2006. 34

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of AIDS-striken families is 70 per cent.38 This staggering statistic underscores the vulnerability of women in Africa and the lack of importance placed on their education. Young women are often placed in positions in which they are not able to refuse sex. Surveys in South Africa reveal that 33 per cent of young women are afraid to say no to sex, and 55 per cent of young women have been forced into sex by their partners. Studies suggest that 11 per cent of Zambian women feel that they have no right to ask their husbands to wear condoms, even if their husbands have tested HIV positive or are known to have had previous sexual partners.39 Supplemental data collected in Botswana shows that 48 per cent of sexually active young women have never used condoms.40 Additionally, marriage no longer prevents young married women from contracting the virus, as unfaithful husbands traveling on business for extended periods of time bring HIV back home.

Benefits of Education Education plays a vital role in fighting and preventing the spread of HIV/AIDS, and is a key aspect to raising awareness and preventively fighting the epidemic. UNICEF maintains that through schooling, children are sheltered from exploitation, have access to basic services such as clean water, and are given knowledge to prevent the further spread of the disease.41 Since the inception of the United Nations, achieving universal primary education was stressed as a means of investing in human capital. Investing human capital through education has led to both economic growth and development. Despite a 20 per cent increase in primary school education in seventy-three developing states between 1970 and 2000, Sub-Saharan African states remain significantly behind their counterparts. The United Nations is deeply concerned about the impact of HIV/AIDS on teachers and the state of education in general. Increased absenteesism caused by the

Ibid. “The Female Face of AIDS” 40 Girls, HIV/AIDS and Education, 9. 41 “Southern Africa - Countries in crisis”. 39

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virus creates an educational dilemma by “eroding and even reversing progress made in achieving universal primary education.”42

Data of teachers in the Central African

Republic in 2000 reports that schools were forced to close due to AIDS related deaths of 85 per cent of teachers.43 In such cases where schools are closed, the development of entire generations is halted and economic development is delayed. With many African states affected by deaths of educators, the education systems in these states experience limited resources, untrained teachers, and crowded classrooms.

UNICEF finds that

children in South Africa, Kenya, Zimbabwe, and Nigeria are most effected by the HIV/AIDS-related deaths of educators. Kenya, Malawi, Nigeria, South Africa, Zambia and Zimbabwe are all forecasted to have teacher shortages in light of this epidemic.44 The closing of rural schools causes many students to flock to urban schools, and those students that can not accommodate the shift most often drop out.45 One of the major problems of the HIV/AIDS pandemic is that there is a general lack of HIV/AIDS education in Africa, as well as inconsistent enrollment in schools. Studies show that many young people do not correctly know how this disease spreads or how to protect themselves from contracting it.46 In a survey taken in sixty African states, a vast majority of youth could not identify how HIV/AIDS is transmitted.47 It is crucial to educate and promote healthy lifestyles and choices in the youth before experimentation with sexual activity; healthy behavior is especially developed between the ages of 10 and 14 in adolescents.48 Combatting HIV/AIDS requires grassroot work that must stress prevention of the virus; merely addressing treatment of those already infected is not enough.

Impact of AIDS, 73. Girls, HIV/AIDS and Education, 7. 44 Impact of AIDS, 73. 45 Girls, HIV/AIDS and Education, 7. 46 Young People and HIV/AIDS: Opportunity in Crisis , 6. 47 “How Wide Spread is the HIV/AIDS Epidemic?” 48 Young People and HIV/AIDS: Opportunity in Crisis, 7. 43

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Current Status UNICEF statistics from 2005 show that there are fifteen thousand new HIV infections each day in children under the age of fifteen. Mother-to-child transmissions account for high infection rates in children, and children born with HIV have a significantly reduced chance of survival, as they have extremely weak immune systems. A staggering 1,400 children die every day from AIDS-related illnesses.49 Of the HIVrelated deaths in 2005, children account for 570,000 out of 3.1 million deaths.50 SubSaharan Africa continues to be one of the most devastated areas, with 25.8 million people infected. Women continue to be vulnerable to HIV. Sub-Saharan statistics show that young African women between 15 and 24 are three times more likely to be HIV positive than males.

The

gender disparities in HIV call for changes in sexual norms within local communities and cultures. In surveys reporting on women who do not have sex until marriage and have a lifetime partner, 40 per cent of these women are HIV positive, proving that a womanâ&#x20AC;&#x2122;s faithfulness to her partner is not enough in Source: http://unicef.org/uniteforchildren/files/U77HIV letter.pdf

combating HIV.51 Infidelity of men, especially when working

away from home for long periods, makes women especially susceptible to contracting HIV. 49

UNICEF, A Call for Action: Children- The Missing Face of AIDS, (New York: UNICEF, 2005), 2. UNAIDS, AIDS Epidemic Update: December 2005, (Geneva, Switzerland: UNAIDS, 2005), 1. 51 Ibid, 9. 50

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The UNAIDS 2005 report asserts, “The key to protecting children is preventing infection in parents. Prevention of mother-to-child transmission is a crucial entry point for primary prevention, treatment, care, and support for mothers, their children, and their families.”52 HIV becomes a bit more manageable when mother-to-child transmission is addressed by taking measures to protect pregnant women and their children against the virus. In South Africa, out of 33,000 pregnant women testing HIV-positive, only 18,857 received antiretroviral prophylaxis, a drug treatment aimed at preventing transmission to the child.

In Kenya and Mozambique, the proportion was similar.

In contrast, in

Uganda, Zambia, and Zimbabwe, almost all the women testing positive were reported to have received antiretroviral prophylaxis.”53 To monitor the infection rates of children, it is essential to look at infection rates in pregnant women.

Southern African states,

especially Botswana, Lesotho, Namibia, South Africa, Swaziland and Zimbabwe, have a 20 per cent or higher HIV infection rate of pregnant mothers.54 South Africa and Mozambique create an especially formidable challenge, as their infection rates continue to increase. Despite such bleak statistics in Southern Africa, many East African states show improvement or stagnation in their infection rates. Decreased infection rates in countries such as Uganda, Zimbabwe, and Kenya prove the positive impact of behavioral changes based on education and HIV prevention programs. The UNAIDS report further asserts, “Indications are that some of the treatment gaps will narrow further in the immediate years ahead, but not at the pace required to effectively contain the epidemic … gaining the upper-hand against AIDS epidemics around the world will require rapid and sustained expansion in HIV prevention.”55

Ibid, 13. Ibid, 13. 54 AIDS Epidemic Update: December 2004, 4. 55 Ibid, 4. 53

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Addressing HIV/AIDS in Africa in a Social Context A statement made by South African President Thabo Mbeki attributed the cause of HIV/AIDS to poverty. While poverty is one of the many facets of AIDS, it is not the sole contributor to the issue. The cause and exacerbations of HIV and AIDS in Africa requires a social and political context as well. Anton van Niekerk maintains, “to become an epidemic, a niche or social context is required. In Africa, besides factors such as relatively recent urbanization, migrant labor, natural and man made disasters … and trade [sex tourism, and the movement, above all, of truckers across the continent], poverty is the main aspect of this niche or social context.”56 To address AIDS in Africa, the causes and cultural implications of poverty need to be taken into account.

van Niekerk

recognizes that prostitution, poor living conditions, education, health, and health care in Africa are he greatest contributing factors to the spread of HIV across the continent. While poverty is considerable challenge, in order to address HIV in Africa, the international community and African governments need to address local aspects of this pandemic. By addressing cultural, microeconomic, and social issues, Africa can work towards achieving the Millennium Development Goals in a feasible manner. Methods of effectively reducing poverty in Africa include “addressing and criticizing conventional sexual and religious morals, making condoms available on a massive scale, cooperating with multinational pharmaceuticals and Western governments to make anti-retroviral drugs available, exploring the import of generic equivalent [of treatment drugs], imaginatively introducing sex education to school curricula, and drawing on the influence of important societal role models.”57

UNICEF Action One of UNICEF’s primary initiatives to fight HIV/AIDS is called Unite for Children Unite Against AIDS campaign.

This campaign provides “child-focused

framework for nationally owned programs around ‘Four Ps’.” The Four Ps include 56

Anton A van Niekerk, “Moral and Social Complexities of AIDS in Africa” in Ethics &AIDS in Africa, Anton A. van Niekerk, Loretta M. Kopelman eds., (Walnut Creek, California: Left Coast Press, 2005) 55. 57 Ibid, 57.

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preventing infections transferred from mother-to-child, providing pediatric treatment, preventing further infection in young people, and protecting and supporting children infected with HIV. Additionally, the Unite for Children Unite Against AIDS campaign aims to place children on the forefront on the HIV/AIDS agenda because they are the future of the face of AIDS.58 UNICEF developed country-specific programs to fight HIV/AIDS which it is implementing in Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe, areas critical in combating the AIDS epidemic. The implementation of key objectives includes identifying child-headed households, expanding HIV awareness and education, strengthening school attendance, improving nutrition, immunization, water sanitation, protection from sexual exploitation, and information management of the status of children.59 In 2004, UNICEF developed the Framework for the Protection, Care and support of Orphans and Vulnerable Children in a World with HIV and AIDS in order to address orphaned children and the vulnerability of children to HIV/AIDS. Additionally, since 2004, UNICEF works with states in developing national plans that work on five broad action areas in addressing HIV/AIDS. This framework includes a plan to: 1. 2. 3. 4. 5.

Strengthen the capacity of families to protect and care for orphans and vulnerable children by prolonging the lives of parents and providing economic, psychosocial and other support Mobilize and support community based responses Ensure access for orphans and vulnerable children to essential services, including education, healthcare and birth registration. Ensure that governments protect the most vulnerable children through improved policy and legislation and by channeling resources to families and communities. Raise awareness at all levels through advocacy and social mobilization to create a supportive environment for children and families affected by HIV and AIDS. 60

The Future of AIDS While AIDS remains an incurable disease, pharmaceutical companies have developed and improved HIV antiretroviral drugs to treat the virus. Due to high research and production costs, HIV treatments were once solely available in North America and

A Call for Action: Children- The Missing Face of AIDS 3. Southern Africa - Countries in crisisâ&#x20AC;?. 60 UNICEF, Children Affected by AIDS, (New York: UNICEF Publications, August 2006), 31. 59

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Europe. Access to such drugs remains elusive especially in Africa where only one in ten HIV infected people needing antiretroviral treatment receive it.

While generic

antiretroviral drugs provide more affordable HIV treatment than brand-name drugs, even these costs are financially taxing on the majority of families and individuals living in moderate and extreme poverty. Providing universal drug access to financially needy states, especially in Sub-Saharan Africa, requires a multi-pronged approach that addresses prevention, treatment, and care of HIV patients.61 Children infected with HIV require specialized HIV treatment and customized antiretroviral dosages. Since immune systems in infants and children vary greatly from adults, antiretroviral therapy (ART) in children needs to have special consideration. Currently, there are twelve approved ART drugs for children. The dilemma in providing ART to infants and young children is the danger of immune system damage if treatment is prematurely started, as studies show that delayed treatment increases life expectancy of treated children.62 UNICEF Deputy Executive Director Rima Salah asserts that “children who have lost parents and care-givers are left without their first line of defense. One of the most effective ways to keep these children safe is to invest in education, especially for girls … we have a moral obligation to act with no delay.”63 Prevention is essential in providing feasible solutions to halting the spread of HIV in line with the Millennium Development Goals.

Through prevention, the subsequent challenges resulting from HIV, namely

treatment and care, decrease in the long term. UNAIDS research provides that intensive and long-term HIV prevention programs have tangible results. A case study in two regions in Tanzania reveals a drop in HIV infection rates from 21 per cent to 15 per cent in women between 1994 and 2000 as a result of a long-term implementation of HIV prevention programs.64 In contrast, shorter prevention projects in another region in 61

AIDS Epidemic Update: December 2004, 5. AIDS InfoNet, “Children and HIV”, <www.aidsinfonet.org> 8 October 2006. 63 Dan Thomas, “Africa’s Orphans at Higher Risk of HIV, Says Report”, < http://www.unicef.org/uniteforchildren/knowmore/knowmore_35341.htm> accessed 26 September 2006. 64 AIDS Epidemic Update: December 2004, 7. 62

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Tanzania revealed a rise in HIV infection rates from 6 to 8 per cent from 1994 to 2000.65 This suggests the importance of long-term prevention programs in effectively preventing the spread of HIV.

Key Positions Southern Africa Southern Africa remains the hardest hit area of the AIDS epidemic. Out of all Southern African countries, South Africa currently displays the highest HIV infection rates. With statistics displaying high rates of infection in pregnant mothers and children, causes for the growing infection rates in this state can be attributed to weak South African political leadership. Critics of President Thabo Mbeki question his support of certain discredited scientists who dispute the theory that AIDS is caused by a virus. This support is seen as an obstacle to creating effective strategies to combat the spread of the virus.66 In addition, South African laws favor patents of pharmaceutical companies that monopolize production of HIV antiretroviral drugs. South Africa honors international patent regulations that allow pharmaceutical companies to maintain monopoly over antiretroviral drugs, and makes distribution of generic drugs, even from other states, illegal.67 Pregnant women in South Africa have 29.5 per cent infection rates, and HIV/AIDS-related deaths of people between the ages of twenty-five and forty-four doubled from 1997 to 2002. Similarly, Mozambiqueâ&#x20AC;&#x2122;s statistics point to a worsening of the HIV pandemic. Between 2002 and 2004, the percentage of people infected with HIV rose from 14 per cent to 16 per cent. Such increases point to interaction in areas with large transport centers connecting to Malawi, South Africa and Zimbabwe.68 As infected people move across borders in Africa and indulge in risky sexual behavior, HIV is spread at an alarming rate, and can be largely attributed to roadside prostitution and the trucking 65

Ibid, 7. Anton A van Niekerk, 57. 67 Ibid, 58. 68 AIDS Epidemic Update: December 2004, 23. 66

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industry, in which men traveling for long periods of time have extra-marital affairs with sex workers, often infected with the virus. Other southern African countries, including Botswana, Lesotho, Namibia and Swaziland, have a 30 per cent or higher rate of pregnant women infected with HIV. While these statistics are relatively high, states such as Lesotho display some stabilization in HIV infection rates in pregnant women. Studies in Madagascar have seen a distinguishable decrease in HIV as 12 per cent of young men and 5 per cent of young women between fifteen and twenty-four years of age report that condom use with casual sex partners.69 Studies in Zimbabwe show that HIV infections in pregnant women decreased from 26 per cent to 21 per cent from 2002 to 2004, which implies a decrease in HIV infection in newborns through mother-to-child transmission.70 Out of all of these Southern African states, Angola surprisingly displays the lowest HIV infection rates.71 Sixteen of the most impacted states in Eastern and Southern Africa have taken an active stance in combating HIV/AIDS in children by assessing, analyzing, and action planning at a national level.72 These states have collaborated with international partners and the international community to develop national plans of action with estimated budgets. While the development of these programs was a monumental task, means of monitoring the implementations of these programs are still in the process of being developed. The initial work of these sixteen Eastern and Southern African states has also been adopted by ten additional Sub-Saharan African states. African states involved in developing and implementing such programs have recognized the need of greater international support and participation of civil society with an emphasis on â&#x20AC;&#x153;budget development and monitoring.â&#x20AC;?73

Ibid, 25. Ibid, 20 71 Ibid, 23. 72 Children Affected by AIDS, 27. 73 Ibid, 28. 70

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East, West, and Central Africa East Africa displays the potential success of implementing key initiatives to combat HIV/AIDS in Africa. For example, Uganda, which has experienced a significant decline in HIV infection rates in the past decade, attributes this successful decline to behavioral changes in its citizens. Although the percentage of youth engaging in premarital sex has remained stagnant, an increased percentage of young men are using condoms. Kenya, implementing similar programs as Uganda, displays similar behavioral changes, where use of condoms with casual partners is increasing. These changes are due to comprehensive HIV education and testing programs.74 The number of infected pregnant women in Kenya has declined drastically as well, from 28 per cent in 1999 to 9 per cent in 2003. Statistics such as these provide hope and serve as models to be implemented in other African states to combat this virus through education.75 Western and Central African states display varied rates of HIV infection rates but generally have lower rates than Southern African states. States in these regions of Africa include Nigeria, Burkina Faso, Togo, Mali, Senegal, Côte d’Ivoire and Ghana. Côte Source of HIV Funding in Burkina Faso

d’Ivoire, Togo, Ghana and Burkina Faso stabilized HIV rates in pregnant women, by addressing mother-to-child transmission.76

Besides

stabilizing

mother-to-child

infections, Western and Central African states need to address infected children, who are the future workforce of their nations.

Without addressing the needs of

children today, these states will have a generational gap in their economic development and a dramatically Source: http://data.unaids.org/pub/GlobalReport/2006 /2006_GR_CH10_en.pdf

decreased population caused by the deaths of HIV infected children. To address children affected by AIDS

today, the Economic Community of West African States (ECOWAS) has partnered with 74

AIDS Epidemic Update: December 2004, 27. Ibid, 25. 76 Ibid, 29 75

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the United Nations Educational, Scientific and Cultural Organization (UNESCO) to develop a system in which community states can share resources and experiences on HIV and AIDS. UNESCO, in collaboration with UNICEF’s regional life skills program, aims to integrate the teaching of life skills into the curriculum of African education systems.77

Developed Western States In Europe, a majority of new HIV infection cases are a result of injecting drugs with unsterile needles by young people between fifteen and twenty-nine years old. In Russia, 80 per cent of officially reported HIV infection cases were a result of injection drugs.78

While new HIV infections are predominantly found in high-risk groups

including those indulging in risky sexual behavoir, homosexuals, and sex workers, infected people are most likely to be able to afford and access antiretrovirals. In response to the global epidemic, the European Union (EU) currently finances 150 laboritories to research new HIV treatments to combat the virus in the future.79 The European Union also stresses importance of HIV prevention through education on safe sexual behavior. To support the international fight against HIV and AIDS in developing states, especially in Africa, the EU has pledged to donate USD $2.6 billion to the United Nations Global Fund to Fight HIV, Tuberculosis and Malaria. This contribution is the largest donation to the fund, which distributes money to developing states to provide additional support for national programs. In addition to supporting UN efforts to combat these potentially deadly diseases, the EU stresses the importance of providing affordable and accessibile antiretroviral drugs to treat currently infected patients.80 The United States plays an important role in the international community’s efforts to fight AIDS, and is committed to combating HIV/AIDS because its government believes the virus “threatens the prosperity, stability, and development of nations around 77

UNESCO, UNESCO’s Response to HIV and AIDS (Paris, France, UNESCO Publications, 2005), 28. Ibid, 46. 79 Manuel Romarís, Simonetta Di Fabio, Jeanne Gervais, Rachida Ghalouci, “HIV/AIDS Research Under FP6” <http://ec.europa.eu/research/health/poverty-diseases/aids_en.html> accessed 8 October 2006. 80 European Commission, “World AIDS Day 2005: EU action to combat resurging epidemic”, 25 November 2005 <http://www.europa-eu-un.org/articles/en/article_5358_en.htm> accessed 8 October 2006. 78

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the world.”81 It donates more funding to the cause of fighting AIDS throughout the world than any other country, and has Emergency Plan HIV programs in one hundred states. The United States Agency for International Development (USAID) assists in implementing President George Bush’s Emergency Plan for AIDS Relief (PEPFAR), a USD $15 billion program that assists in preventing the spread of HIV/AIDS and treating and caring for HIV patients abroad. This program was initiated in 2003 with the aim to “provide treatment to at least two million HIV-infected individuals, prevent seven million new HIV infections, and provide care and support to 10 million people living with and affected by HIV/AIDS, including orphans and vulnerable children.”82 This program has fifteen target countries, including Botswana, Cote d’Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam and Zambia. The United States is also concentrating on making AIDS drugs more available to countries in Africa and elsewhere in an attempt to reduce HIV transmission from mothers to infants.83 President Bush announced a new USD $500 million International Mother and Child HIV Prevention Initiative that seeks to prevent the transmission of HIV/AIDS from mothers to infants and to improve health care delivery in Africa and the Caribbean. Through a combination of improving care and building healthcare delivery capacity, this new effort is expected to reach up to one million women annually and to reduce motherto-child transmission by 40 per cent within five years or less in twelve African countries and the Caribbean. Since much of the hope of AIDS victims in Africa lies in drugs and programs that require funding, the United States has become one of the greatest sources for their aid.

USAID, “Welcome”, < http://www.usaid.gov/our_work/global_health/aids/> accessed 25 September 2006. Ibid. 83 USAID Global Health: HIV/AIDS, Technical Areas, Mother-to-Child Transmission,” USAID, <http://www.usaid.gov/pop_health/aids/TechAreas/mtct/index.html> (3/5/03) 82

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Latin America and the Carribbean Latin America and the Carribbean face continually increasing HIV infection rates. Latin American HIV infections are predominantly found in individuals engaging in risky behavior, including unprotected homosexual sex and the use of unsterilized needles. Latin American states, especially Brazil, rely heavily on antiretroviral drug treatments to treat HIV cases. Brazil has an exemplary HIV/AIDS treatment program for HIV positive citizens, providing free medication and treatment to infected persons. Domestically, the high costs of brand-name antiretroviral drugs in relation to generic versions of antiretrovirals caused Brazil to negotiate a deal with Abbot Laboritories, a Brazilian drug company.

Brazil threatened to violate patents and produce generic versions of the

antiretroviral drug if the drug company did not reduce the cost of the drug to an affordable level. Subsequently, in 2005, Abbot Laboratories came to an agreement with the Brazilian government and agreed to halve the price of the treatments.84 The Brazilian healthcare model is an exemplary model in HIV treatment. While Latin American infection rates are predominantly in high-risk groups, the Caribbean region, including Haiti, the Bahamas, Barbados, the Dominican Republic, and Guyana, represents infections throughout the general population, similar to the situation in much of Africa.85 Similar to Africa, 83 per cent of HIV infections in the Caribbean are primarily in the working generation between fifteen and fifty-four.86

Asia While Asian states do not have rampant HIV infection rates, they are still affected by the disease. In China, infection rates are attributed to drug injections without steril needles, rather than to mother-to-child transmission or unsafe sexual contact. 84

It is

Paulo Prada, “Brazil Near Deal With Abbott for Price Cut on AIDS Drug” New York Times 5 October, 2005 <http://www.nytimes.com/2005/10/05/business/worldbusiness/05abbott.html?ex=1160625600&en=3db23bc7d85a0 102&ei=5070> (accessed 10 October, 2006). 85 Tony Barnett and Alan Whiteside, AIDS in the Twenty First Century: Disease and Globalization (Great Britain: Palgrave Macmillan, 2006), 11. 86 Joelle Dehasse, “Caribbean Countries Face Ominous Threat of AIDS” 6 July 2000 <http://wbln0018.worldbank.org/external/lac/lac.nsf/60d24d5a675982ea852567d6006cb7ca/9452a7a89510428b852 56914006c6b2f> (accessed 10 October 2006).

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estimated that injection related tranmissions account for 43.9 per cent of methods of infection.87

China initiated a ‘Four Frees and One Care’ program that provides

antiretroviral drugs for free to prevent mother-to child transmission, as well as free schooling for orphaned children and economic assistance for affected families. This program has reached 25 per cent of the Chinese population infected with HIV access to antiretrovirals. This is a exceptional proportion of the HIV infected population receiving necessary drugs, thus making China’s program a possible model to be implemented in other states.88 It should be noted that despite this seemingly successful program, it is widely believed that China severely underreports its HIV infection rate. India is known to have a rapidly increasing rate of new HIV infections, and two thirds of HIV infections in the Asian continent are in India. Although there is an increasing HIV infection rate in this state, India plays a central role in the manufacturing of generic antiretroviral drugs.

With a large generic antiretroviral pharmaceutical

industry, many states turn to India for affordable drug treatments. The World Health Organization (WHO) made a temparory waiver for states lacking established pharmaceutical industries to import generic first-line antiretroviral drugs from India in 2005. This waiver assisted thirty six states in Africa to obtain cheaper, generic HIV antiretrovirals. In the same year, India also altered its patent laws to comply with patents of international pharmaceuticals, making the future of its generic second-line antiretroviral production uncertain, as its first-line antiretrovirals become resistant.89

Middle East The first recorded cases of HIV/AIDS in the Middle East occurred in Bahrain, Qatar, and Iran in the mid 1980s. Despite the presence of this disease, Islamic states in the Middle East refuse to address means of treating and preventing the spread of this virus due to implications of premarital sex, prostitution, homosexuality, and the use of 87

AIDS Epidemic Update: December 2004, 32 UNAID, “Fact Sheet: Asia”, <http://data.unaids.org/pub/GlobalReport/2006/200605-FS_Asia_en.pdf> accessed 8 October 2006. 89 UNAIDS, 2006 Report on the Global AIDS Epidemic (New York: UNAID publications, 2006) p165 <http://data.unaids.org/pub/GlobalReport/2006/2006_GR_CH07_en.pdf> accessed 8 October 2006. 88

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drugs.90 The stress on Islamic religious views and way of life does not acknowledge the reality of these activities in this region, thus, making it difficult for to address this pandemic at a regional level. Middle Eastern states such as Pakistan assert that ‘better social and Muslim values’ of Islamic culture prevent the spread of HIV, a claim that is clearly not verifiable, as a large proportion of the HIV positive African population is Muslim. The failure to separate religion from health policy hinders the Middle East from planning and establishing plans to combat HIV. Despite these hurdles, Iran implemented reforms in 2002 to change previous practices of discrimination against HIV positive workers and ended the right of medical staff to refuse treatment to HIV positive patients. Former President Mohammad Khatami of Iran implemented new initiatives to incorporate a mandatory HIV/AIDS education into school curriculum as well as to provide for sterile needle-exchange programs. The progressive actions of one of the most conservative Islamic states in the Middle East have not been adopted by other states such as Iraq, Afghanistan and Saudi Arabia, who blame the spread of the disease on foreigners.91 At the 2001 Special Session on HIV and AIDS at the United Nations, the Islamic bloc refused to support the Declaration of Commitment, stating their moral objections to the support of at-risk groups such as homosexuals and prostitutes.92 Even when the section of the declaration that emphasized support of these groups was removed, the Islamic bloc would not commit to the session’s proposed AIDS pact.93 Middle Eastern states support the effort to fight AIDS as is shown by their participation in world conferences, but they refuse to provide any proposed aid contradicting morals propounded in religious scriptures.

Laura M. Kelley and Nicholas Eberstadt, “The Muslim Face of AIDS,” Foreign Policy, Issue 149 (July/August 2005) EBSCO Host, <http://web.ebscohost.com> p44, accessed 8 October, 2006. 91 Ibid, 46-47. 92 Riley, Mark “Islamic Nations Block AIDS Pact Again,” globalpolicy.org <http://www.globalpolicy.org/socecon/develop/aids/2001/islamicbloc0627.htm> (3/5/03) 93 Ibid.

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Summary It is critical to place “the missing face of children affected by AIDS at the center of the HIV/AIDS agenda”.94 The exceptionally high rate of HIV/AIDS infections in Africa highlights the need for sustained cooperation between developed and underdeveloped states to implement feasible solutions in addressing this pandemic. Children are the future in combating this deadly virus. The AIDS epidemic is the greatest threat to Africa’s children. Killing thousands of people each year, the HIV virus leaves children vulnerable to sickness, famine, and loss of family. The social and economic problems caused by the epidemic have an especially severe effect on children. HIV/AIDS is increasingly on the forefront of international concerns; it requires immediate attention and implementation of programs to address the pandemic by focusing on the future of Africa: the children. AIDS orphans thousands of children in Africa each year, leaving them with the responsibility of heading their own households. Some international programs have begun to recognize the importance of giving these children counseling, life-skills training, and increased social support within their own communities. While UNICEF has sponsored programs to help provide these things and concentrated on educating children and teenagers about the prevention of HIV infection, the ‘missing face of children affected by AIDS’ needs to become the primary means of addressing this global issue. The importance of aiding Africa in its fight against HIV/AIDS is recognized by states, the United Nations, and non-governmental organizations (NGOs). International conferences and awareness events are becoming increasingly common. The Joint United Nations Program on HIV/AIDS is one of the first clear steps in uniting worldwide effort for this cause. The necessity of bringing together non-government organizations, local communities, governments, and other world powers to fight this crisis is reaffirmed through the development of individualized programs to be implemented at state and local levels, as well as international support in combating HIV/AIDS. 94

A Call for Action: Children- The Missing Face of AIDS, 3.

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Discussion Questions • What are some feasible solutions for the international community in halting the spread of HIV/AIDS in children in the next 10 years? 25? 50? Are these solutions different than solutions for specific governments? • Since mother-to-child transmissions are the most common form of HIV infections in children in Africa, what can UNICEF practically do to address this situation? • Should HIV/AIDS education be mandatory throughout African schooling systems? • What kinds of legislation exist to combat sexual exploitation of children? Can such legislations be reinforced and what would UNICEF’s role be in the reinforcement of a state’s legislation? • What incentives do pharmaceuticals have to sell more affordable drugs if they have heavily invested funds for research and development of HIV and HIDS drugs? What would allow companies willing to sell drugs at a cheaper rates into the market? • What kinds of programs can increase awareness of the sex trade and its related problems? • What should the role of developed countries be in addressing the HIV/AIDS issue in Africa? Should they be obligated to provide their research and technology at cheaper rates to African states? • Long-term programs have proven to reduce HIV infection rates in certain African countries. Where can developing African states obtain funding to sustain such programs? What role do the United Nations agencies, governments, and NGOs play in developing and funding long-term programs? • What are feasible solutions to continuing education in children whose parents are affected/killed by HIV/AIDS? • How can UNICEF work with non-government organizations to aid victims and spread awareness about sexual exploitation issues?

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Works Cited Adeyi, Olusoji, Kanki, Phyllis J. Odutolu, Oluwole, and Idoko, John A ed. AIDS in Nigeria: A Nation on the Threshold. Cambridge: Harvard University Press, 2006. AIDS InfoNet, “Children and HIV”, www.aidsinfonet.org. Barnett, Tony and Whiteside, Alan. AIDS in the Twenty First Century: Disease and Globalization. Great Britain: Palgrave Macmillan, 2006. BBC News, “BBC News/Africa/Aids,” http://news.bbc.co.uk/hi/english/static/in_depth/africa/2000/aids_in_africa/default. stm. Bloom, David E. “Something to Be Done: Treating HIV/AIDS” Science 288, No. 5474 (23 June 2000). Dehasse, Joelle. “Caribbean Countries Face Ominous Threat of AIDS”. 6 July 2000, http://wbln0018.worldbank.org/external/lac/lac.nsf/60d24d5a675982ea852567d60 06cb7ca/9452a7a89510428b85256914006c6b2f. European Commission, “World AIDS Day 2005: EU action to combat resurging epidemic”, 25 November 2005 http://www.europa-euun.org/articles/en/article_5358_en.htm. Kelley, Laura M. and Eberstadt, Nicholas “The Muslim Face of AIDS,” Foreign Policy, Issue 149 (July/August 2005) EBSCO Host, http://web.ebscohost.com. Lynch, Colum “Islamic Bloc, Christian Right Team Up to Lobby U.N.,” Sullivancounty.com, http://www.sullivan-county.com/id2/ci_unite.htm. Prada, Paulo. “Brazil Near Deal With Abbott for Price Cut on AIDS Drug” New York Times. 5 October, 2005 http://www.nytimes.com/2005/10/05/business/worldbusiness/05abbott.html?ex=1 160625600&en=3db23bc7d85a0102&ei=5070. Riley, Mark “Islamic Nations Block AIDS Pact Again,” globalpolicy.org http://www.globalpolicy.org/socecon/develop/aids/2001/islamicbloc0627.htm. Romarís,Manuel, Di Fabio,Simonetta, Gervais,Jeanne, Ghalouci,Rachida. “HIV/AIDS Research Under FP6” http://ec.europa.eu/research/health/povertydiseases/aids_en.html.

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Thomas, Dan. “Africa’s Orphans at Higher Risk of HIV, Says Report”, http://www.unicef.org/uniteforchildren/knowmore/knowmore_35341.htm. UNAIDS. AIDS Epidemic Update: December 2005.Geneva, Switzerland: UNAIDS, 2005. UNAID, “Fact Sheet: Asia”, http://data.unaids.org/pub/GlobalReport/2006/200605FS_Asia_en.pdf. UNAIDS. 2006 Report on the Global AIDS Epidemic. New York: UNAIDS publications, 2006. http://data.unaids.org/pub/GlobalReport/2006/2006_GR_CH07_en.pdf. UNAIDS, “UNAIDS in Action”, http://www.unaids.org/en/Coordination/default.asp. UNESCO. UNESCO’s Response to HIV and AIDS. Paris, France: UNESCO Publications, 2005. UNICEF, “The Big Picture”, http://unicef.org/aids/index_bigpicture.html?q=printme. UNICEF. A Call for Action: Children- The Missing Face of AIDS. New York: UNICEF Publications, 2005. UNICEF, Children Affected by AIDS. New York: UNICEF Publications, 2006. UNICEF, “The Female Face of AIDS”, http://unicef.org/aids/23538_female_face_aids.html. UNICEF. Girls, HIV/AIDS and Education. New York, UNICEF Publications, 2004. UNICEF, “How Does HIV/AIDS affect Girls and Women?”, http://unicef.org/aids/index_hivaids_girls_women.html. UNICEF “How does HIV Affect Young People?” http://unicef.org/aids/index_youngpeople.html. UNICEF, “How Wide Spread is the HIV/AIDS Epidemic?”,http://unicef.org/aids/index_epidemic.html. UNICEF , “Southern Africa - Countries in crisis”, http://www.unicef.org/emerg/southernafrica/index.html.

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UNICEF, “UNICEF in Action”, http://unicef.org/aids/index_action.html. UNICEF, “Why Children and Aids”, http://unicef.org/uniteforchildren/knowmore/knowmore_28763.htm. UNICEF, “What is HIV/AIDS?, http://unicef.org/aids/23538_hivaids.html. United Nations Children’s Fund, Joint United Nations Program on HIV/AIDS and World Health Organization. Young People and HIV/AIDS: Opportunity in Crisis. New York: UNICEF Publications, 2002. United Nations. The Impact of AIDS. New York: UN Publications, 2004. US AID, “Welcome”, http://www.usaid.gov/our_work/global_health/aids/. US AID, “USAID Global Health: HIV/AIDS, Technical Areas, Mother-to-Child Transmission,” http://www.usaid.gov/pop_health/aids/TechAreas/mtct/index.html. Van Niekerk, Anton A. “Moral and Social Complexities of AIDS in Africa” in Ethics & AIDS in Africa. van Niekerk, Anton A. and Kopelman, Loretta M. eds.. Walnut Creek, California: Left Coast Press, 2005.