Protecting Childhood in the AIDS Pandemic Finding Solutions that Work

Every year over a quarter of a million children die of AIDS. Another two million children currently live with HIV, most in sub-Saharan Africa. Millions more are affected when AIDS enters their families or their communities. Orphans are perhaps the most visible: 15 million children have lost one or both parents to AIDS; 12 million of them live in sub-Saharan Africa. The increasing burden of care due to HIV/AIDS falls mainly on extended family: first they care for the sick and dying relatives, and then they take responsibility for the children left behind. Today, the extended family cares for over 90% of double orphans. Adults who take on these immense caregiving burdens have less time for their own children, fewer financial resources, and greater difficulties securing food and shelter. Thus, children who have parents providing care to sick relatives or who share scarce resources with foster children may also experience disadvantage. In communities severely affected by AIDS, traditional safety nets are often eroded by cumulative mortality: teachers are absent from school because of their own illness or that of family members, and basic health facilities can be overwhelmed by AIDS care needs, all of which leave children increasingly vulnerable. The impact is most severe in environments where government- and state-level support is weakest-where universal education, health care, and social welfare are either partially available or not available at all. Protecting Childhood in the AIDS Pandemic will bring together lessons from experts around the world on what has worked, and what would need to be done to transform the outcomes of children of all ages whose lives have been affected by HIV/AIDS. Examining which public policies and programs have worked best to meet the full range of children's needs, from medical care to social support and from infancy to adolescence, this is the volume for academics, social scientists, policymakers, and on-the-ground practitioners.

1. Meeting the Essential Needs of All Children. Jody Heymann, Lorraine Sherr, and Rachel Kidman. Part I. The Critical Context of Children's Lives. . 2. Even When They're Ill: The Central Role of Families in the Lives of Children Affected by AIDS. Linda M. Richter. 3. Strength Under Duress: Community Responses to Children's Needs. Geoff Foster, Nathan Nshakira, and Nigel Taylor. Part II. Challenges to Child Development. 4. Early Childhood: The Building Base for the Future. Patrice L. Engle. 5. Education in a Pandemic: The Needs of School-age Children. Xiaoming Li and Yan Guo. 6. Healthy Minds: Psychosocial Interventions for School-Aged Children. Lucie D. Cluver, Malega Kganakga, Mark E. Boyes, and Mihyung Park. 7. Transition into Adulthood: The Changing Needs of Youth. Simona Bignami-Van Assche and Vinod Mishra . Part III. Meeting Health Care Needs. . 8. Effective HIV Prevention and Treatment for Pregnant Mothers and Their Children. Hoosen Coovadia and Marie-Louise Newell. 9. Breaking the Cycle: Challenges and Solutions in Pediatric HIV Policy. Liezl Smit, Angela Dramowski, Kevin Clarke, Janine Clayton, Annemadelein Scherer, Amy Slogrove, Happyson Musvosvi, Marina Rifkin, and Mark Cotton. Part IV. Getting Delivery Done Well. 10. Choices and Consequences: Should Resources Be Specifically Targeted to Children Affected by AIDS?. Michelle Adato. 11. Whose Responsibility is It Anyway? Four Perspectives. View 1. Moving From Abrogation to Shared Responsibility. Douglas Webb. View 2. Responsibility, Accountability, and Government (In)action. Agnes Binagwaho. . View 3. Children's Rights and the Responsibility of All Stakeholders. Stefan E. Germann, Stuart Kean, and Rachel Samuel. View 4. The Responsibility to Not Turn Away. Chris Desmond.

Jody Heymann, MD, PhD, is the Founding Director of the Institute for Health and Social Policy at McGill University. An internationally renowned researcher on public policy and equity, Heymann has authored more than 170 publications, including ten books. Her work has been featured widely on CNN, Good Morning America, Fox News, and NPR, among other leading national and international media. Lorraine Sherr, PhD, is a clinical psychologist and academic working in London with wide national and international research and policy experience. She has authored over 255 publications on the subject of HIV infection generally and families particularly. She has sat on the World Health Organization's Strategic Organizational committee and has been awarded a Churchill Fellowship for work on mothers and infants in HIV. Rachel Kidman, PhD, is a Research Assistant Professor in the School of Public Health and Tropical Medicine at Tulane University, where her research focuses on the development of appropriate social interventions to help protect the welfare of children affected by AIDS. She has conducted research on health and educational disparities and programs serving vulnerable children and their families in sub-Saharan Africa.