The State of the World's Children 2000

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Undeclared war

AIDS: A deathly, deadly silence

Each day 8,500 children and young people around the world are infected with HIV18 and 2,500 women die from AIDS19. In 1998 alone, the number of women killed by HIV/AIDS was 900,000-more than three times the death toll of the war in Bosnia.20

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 HIV21. 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.    
Copyright© 1999 UNICEF/97-0073/Horner
In Thailand, a woman sick with AIDS holds her baby daughter.

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 five 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.22

Any visitor to villages where AIDS has been an aggressive invader finds a legacy of huts deserted, fields fallow, children stunned and orphaned.23 Equally haunting are the trauma and the long-term devastation. Parents fall ill and waste away; children, and particularly adolescents, 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. More than 10 million of these children under the age of 15 live in Africa today,24 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 known in 1960, and even earlier.25 Of the nine countries with the highest adult 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 had 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 by this same period.26

There can be little doubt that the same catastrophic combination of stigma, taboo and silence that continues to fuel the deadly epidemic in sub-Saharan Africa is repeating itself in South Asia. Since HIV/AIDS appeared in South Asia in 1986, more than 5 million people in the region have been infected with the virus, about half of them women.27 There too, the social powerlessness of women means large numbers are being infected with HIV by their husbands. In a study of nearly 400 women attending clinics in the Indian city of Pune, nearly one fourth had a sexually transmitted infection, although 91 per cent said they had only had sex with their husbands; 13.6 per cent tested positive for HIV.28

Copyright© 1999 UNICEF/5235/Toutounji
A Lebanese girl stands at the doorway of her home.
    One of the most outrageous dangers to children in South Asia is their invisibility in the HIV/AIDS pandemic. Whatever information is collected is not disaggregated to show the disease's effects on children. This makes it all the more difficult to identify those whose rights are most at risk and protect them from further harm.

Meanwhile, 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 obstacles to realizing the rights of children in the 21st century are daunting, it is true. But it is in the significant achievements of the last decades, many in the face of considerable constraints, that hope for the future is found: improvements in child survival rates and the nutritional status of children, strengthened systems of basic education and health services, improved conditions for water and sanitation. It is from these accomplishments and from the vision and language of possibility that surround the 2001 meeting of global leadership that optimism springs: The barriers to all children everywhere realizing their rights can and will be broken within a single generation.

See also:

Figure 1: The growing gap between rich and poor countries

Figure 2: The distribution of income in three large economies

Figure 3: Increase in number of complex emergencies

Figure 4: Prevalence of violence against women by an intimate male partner in any relationship

Figure 5: Poverty and HIV prevalence

Panel 2: Indonesia's despair

Panel 3: Children's risks in societies on the edge

Panel 4: Zambia: Hope in the AIDS epicentre

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