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The Guardian (London), December 10, 2004
The
greatest catastrophe
AIDS worst disaster in history, says UN chief
The HIV/Aids pandemic is the worst catastrophe
in history and is blighting childhood across
the developing world, especially sub-Saharan
Africa, the United Nations said yesterday.
Advances in children's survival, health and education
are being reversed by a "triple whammy"
of Aids, conflict and poverty, according to
the UN children's agency, Unicef.
The disease is driving the destruction of basic
services for 1bn children and violating their
right to grow and develop, said Carol Bellamy,
the organisation's executive director.
"We believe Aids is the worst catastrophe
ever to hit the world," she told the Guardian.
"It is just ripping up systems, be it
health or education. Our children's childhood
is being robbed from them."
But the agency and Ms Bellamy have been strongly
criticised by the editor of one of the world's
leading medical journals, the Lancet.
In an editorial published today, Richard Horton
said Unicef's "preoccupation" with
children's rights meant that the fundamental
right to survival was, "shamefully",
not at the core of its work. "In sum,
for almost a decade, child survival has failed
to get the attention it deserves," he
writes.
In Unicef's 150-page annual report, The State
of the World's Children 2005, the agency paints
a bleak picture of sub-Saharan Africa slipping
further behind other developing regions such
as southern Asia, Latin America and the Caribbean.
Researchers also found that
* Of the 15 million children orphaned by Aids,
80% are African
* One in six (90 million) children are severely
hungry
* One in seven (270 million) have no healthcare
at all
* Nearly half of the 3.6 million people killed
in war since 1990 have been children.
"Unless action is taken, swiftly and decisively,
to stem the tidal wave of infection and loss,
it is estimated that by 2010 over 18 million
African children will have lost one or both
parents to HIV/Aids," said Ms Bellamy.
She said there were bright spots: an effort to
eradicate polio was back on track, Kenya had
introduced free primary schooling and rates
of HIV appeared to be falling in Namibia. "We
are not saying everything has fallen apart."
But without identifying them she accused governments
of "shutting their eyes" to HIV and
the erosion of gains made since the adoption
of the convention on the rights of the child
in 1989.
The report sounded alarm over the growing number
of orphans deprived of a normal family environment
and exposed to violence, abuse, exploitation
and stigmatisation.
"The loss of a parent implies more than
just the disappearance of a caregiver. It pervades
every aspect of a child's life: their emotional
well-being, physical security, mental development
and overall health. In the most extreme cases,
children can find themselves living on the
streets, utterly devoid of family support."
The extended African family network of grandparents,
uncles, aunts and cousins has been credited
with shouldering the burden but Unicef warned
that this safety net was severely stretched,
especially in Botswana, Lesotho, Swaziland
and Zimbabwe.
Aid workers and government agencies have issued
similar warnings that romanticised notions
of heroic relatives selflessly raising broods
of infants can mask an uglier reality.
In the South African village of Kamhlushwa, for
example, an uncle offered to care for the six
Ndlovu children, aged four to 11, after both
parents died earlier this year. But neighbours
said he was interested only in their social
grants and that it would be better if the eldest
child, Thembeni, were the head of the household.
Around 1.9 million children under the age of
14 in sub-Saharan Africa had the HIV virus,
said the report, and around 1,700 children
worldwide became infected every day. But few
African countries had followed Brazil's lead
in giving life-extending anti-retroviral drugs
to children and adolescents as part of a national
treatment programme.
Social indicators in many parts of Asia, Latin
America and the Caribbean showed improvement
but almost half of the world's 2.2 billion
children lived in poverty.
In a foreword to the report, the UN secretary
general, Kofi Annan, said that for such chil
dren reality was "starkly and brutally
different" from the ideals of the millennium
declaration adopted in 2000 as a blueprint
for the 21st century.
"Poverty denies children their dignity,
endangers their lives and limits their potential.
Conflict and violence rob them of a secure
family life, betray their trust and hope. With
the childhood of so many under threat, our
collective future is compromised."
The report is likely to be welcomed by Tony Blair
and Gor don Brown as another spur to their
plan to write off African debt, tackle disease
and break down trade barriers during Britain's
presidency next year of the G8 industrial nations.
But Ms Bellamy said that after a decade at Unicef
she considered the development glass half full,
not half empty.
However, Mr Horton is scathing of Unicef's approach.
In his editorial he is specifically critical
of Ms Bellamy, saying it has been her "distinctive
focus" to advocate the rights of chil
dren. "This rights-based approach to the
future of children fits well with the zeitgeist
of international development policy,"
he writes. "But a preoccupation with rights
ignores the fact that children will have no
opportunity for development at all unless they
survive.
"The language of rights means little to
a child stillborn, an infant dying in pain
from pneumonia or a child desiccated by famine.
The most fundamental right of all is the right
to survive. Child survival must sit at the
core of Unicef's advocacy and country work.
Currently, and shamefully, it does not."
He adds: "Child health needs better leadership,
improved coordination of services and increased
funding."
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