More Than 1B Children Worldwide Face ‘Brutal Existence’ Because of HIV/AIDS, Poverty, Conflict, UNICEF Report Says

More than one billion children worldwide face a "brutal existence" because of HIV/AIDS, poverty and armed conflict, according to a UNICEF report released Thursday, BBC News reports (BBC News, 12/9). The annual report, titled "Childhood Under Threat," examines the impact of HIV/AIDS, poverty and war -- three of the most "widespread and devastating factors threatening childhood today" -- on children around the world, according to a UNICEF release. Working in collaboration with researchers from the London School of Economics and Bristol University, UNICEF found that more than one billion children are "denied the healthy and protected upbringing" guaranteed by the 1989 United Nations Convention on the Rights of the Child, according to UNICEF Executive Director Carol Bellamy (UNICEF release, 12/9).

HIV/AIDS
According to Peter McDermott, head of UNICEF's HIV/AIDS program, the pandemic's impact on children is "huge and getting worse. In fact, the worst is yet to come" (AFP/Yahoo! News, 12/8). Almost 500,000 children under 15 years old died of AIDS-related causes in 2003, and an additional 630,000 children were infected with HIV during 2003, according to UNICEF estimates. Approximately 2.1 million children under age 15 were living with HIV/AIDS in 2003, most of whom contracted the virus in utero, during birth or through breastfeeding, according to the report. The number of children worldwide who have lost one or both parents to HIV/AIDS increased from 11.5 million to 15 million between 2001 and 2003, and 80% of those children live in sub-Saharan Africa (AP/Yahoo! News, 12/9). The report also estimates that by 2010, more than 18 million African children will have lost one or both parents to AIDS-related causes unless "swift action [is] taken," Reuters reports (Lovell, Reuters, 12/9). AFP/Yahoo! News reports that millions of children also were "transformed into care providers for sick parents and siblings" between 2001 and 2003 (AFP/Yahoo! News, 12/8). "AIDS is the new factor in the last decade or so on the block, and it is having a vicious effect in some countries," David Agnew, president of UNICEF Canada, said, adding, "There is absolutely no question that in some countries, we are going backwards, and those are countries that are affected by intense and enduring conflict -- or the majority of them are the ones that have the highest HIV infection rates and AIDS death rates" (Oziewicz, Globe and Mail, 12/9).

Other Findings
The report also found that approximately 640 million children worldwide lack adequate shelter; 400 million children do not have access to safe water; 270 million children do not have access to health care; and 140 million children, most of whom are girls, have never attended school (AFP/Yahoo! News, 12/8). The mortality rate for children under five in sub-Saharan Africa in 2003 was 175 deaths per 1,000 children, compared with a world average of 80 deaths per 1,000 children. The report also determined that maternal mortality in sub-Saharan Africa in 2003 was 940 deaths per 100,000 live births, compared with a global average of 400 deaths per 100,000 live births (Reuters, 12/9). Of the 27 countries with the highest child mortality rates, 26 are located in Africa -- only Afghanistan was outside of the region. According to the report, Sierra Leone is the "most deadly place for a child," with a mortality rate for children under age five at nearly 30%, according to the Boston Globe (Donnelly, Boston Globe, 12/9). Almost half of the 3.6 million people killed in armed conflict worldwide since 1990 have been children, according to UNICEF. "Too many governments are making informed, deliberate choices that actually hurt childhood," Bellamy said, adding, "When half the world's children are growing up hungry and unhealthy, when schools have become targets and whole villages are being emptied by AIDS, we've failed to deliver on the promise of childhood" (BBC News, 12/9).

Reaction
Although Bellamy said that the "blame mostly rest[s]" with countries that failed to adequately address the HIV/AIDS pandemic and poverty or prevent armed conflict, some of her "critics" said the report was "full of evidence that she had failed to emphasize childhood survival," according to the Globe (Boston Globe, 12/9). In a comment published in the Dec. 3 issue of the journal Lancet, editor Richard Horton wrote that it is "widely, if regrettably, accepted that UNICEF has lost its way during Carol Bellamy's long term of office" (Horton, Lancet, 12/3). "The right to survival is the most critical right for a child," Dr. Robert Black, chair of international health at the Bloomberg School of Public Health at Johns Hopkins University, said, asking, "If we can't put our focus on that, how meaningful is the rest of the discussion on child rights?" However, Bellamy, who will step down as UNICEF executive director next year, has "defended her priorities over the past decade" and said she was "proud we have embraced a child's rights approach, advocating that children not be seen as charitable instruments, if you will, but human beings that have rights," the Globe reports. She added that "child rights has not been a diversion from survival. The rights of a child are not only to survive but to thrive, not to become a victim of HIV/AIDS, not to be exploited, not to be abused. The world doesn't stop at simple survival." Mark Rosenberg, executive director of the Task Force for Child Survival and Development who supports Bellamy's view, said that her successor should "develop closer relationships" with other U.N. agencies, especially the World Health Organization, as well as the U.S. government and organizations, such as the Bill and Melinda Gates Foundation, according to the Globe (Boston Globe, 12/9).