The "worst catastrophe ever"

UNICEF sounds an alarm on the state of the world's children: Almost half live in poverty, and about 1,700 are infected with HIV every day.

Published December 10, 2004 2:42PM (EST)

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 Thursday. Advances in children's survival, health and education are being reversed by a "triple whammy" of AIDS, conflict and poverty, according to the U.N. children's agency, UNICEF. The disease is driving the destruction of basic services for 1 billion children and violating their right to grow and develop, said Carol Bellamy, the organization'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 Bellamy have been strongly criticized by the editor of one of the world's leading medical journals, the Lancet. In an editorial published Friday, 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 percent 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 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 an alarm over the growing number of orphans deprived of a normal family environment and exposed to violence, abuse, exploitation and stigmatization. "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 romanticized 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, ages 4 to 11, after both parents died earlier this year. But neighbors 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 have HIV, said the report, and around 1,700 children worldwide become infected every day. But few African countries have followed Brazil's lead in giving life-extending anti-retroviral drugs to children and adolescents as part of a national treatment program.

    Social indicators in many parts of Asia, Latin America and the Caribbean show improvement but almost half of the world's 2.2 billion children live in poverty. In a foreword to the report, U.N. Secretary-General Kofi Annan said that for such children reality is "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 Prime Minister Tony Blair and Chancellor of the Exchequer Gordon 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 G-8 industrial nations. But Bellamy said that after a decade at UNICEF she considered the development glass half-full, not half-empty.

    However, the Lancet's Horton is scathing of UNICEF's approach. In his editorial he is specifically critical of Bellamy, saying it has been her "distinctive focus" to advocate the rights of children. "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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