- The Washington Times - Monday, March 8, 2004

SANTO DOMINGO, Dominican Republic — Twenty-five million children around the world roughly half the number in U.S. public schools will become AIDS orphans by 2010, according to a study to be published next month.

There are about 14 million children worldwide orphaned by AIDS-related deaths, and their number is growing by 800,000 per year, according to the study conducted by the Washington-based International AIDS Trust (IAT).

About 600,000 of the newly orphaned children of AIDS victims live in Africa, which has been hardest hit by the pandemic, but the effect on children worldwide will worsen as the number of women with HIV grows to 50 percent of those infected.

“The numbers are just mind-boggling,” said Sandra L. Thurman, president of the IAT, a nonprofit organization. “We cant even begin to get our heads around the social and anthropological consequences of this, because we are just at the beginning of this epidemic.”

The IAT report will be submitted to the U.S. Congress on April 7.

Ms. Thurman, the first presidential envoy for AIDS cooperation under President Clinton, spoke on the sidelines of a weekend Caribbean conference of about 1,800 health professionals that ended Sunday.

The Caribbean region, which has the second-highest infection rate after Africa, has about 250,000 AIDS orphans, about 200,000 of them in Haiti.

The study, conducted in conjunction with the Children Affected by AIDS Foundation, uses the United Nations Childrens Funds definition of an AIDS orphan as having lost one parent or both.

Besides social stigma and emotional stress, orphans suffer loss of food, education, health care and security, and are more vulnerable to exploitation. About a million children, many of them orphans, are forced into the sex industry every year, according to IAT figures.

Many, though, die sooner. Every day, more than 2,000 infants contract HIV at birth from their mothers, and most die before their fifth birthday. In 2001, 580,000 infants died of AIDS, according to IAT figures.

More than 90 percent of AIDS-infected infants acquire HIV from their mothers, a transmission path that can be interrupted by a one-time dose of the drug Nevirapine, available for $8.

With testing and counseling, the cost could rise to $100 or more per mother and child, but the treatment is still a “great return for your investment,” Ms. Thurman said.

The drug, made by Boehringer Ingelheim, reduces the chances of mother-to-child transmission nearly 50 percent, the World Health Organization confirmed in July. It must be administered to the mother at the onset of labor and to the infant within 72 hours of birth.

Mothers milk is another primary means of transmission. Scientists say this is an area where more research is urgently needed, because most mothers have no choice about how to nourish their babies.

Women account for more than half of all those infected with HIV/AIDS, and the percentage is growing. Concern for halting HIV transmission to children should not lead to neglect of mothers, Ms. Thurman said.

“If we manage to save the babies but dont do anything to save the mother, then we are creating orphans,” she said. “We have to try to keep these mothers alive, because we know from decades of research that every day we can keep a child with its mother, the more viable that child is physically and psychologically.”

Girls are five to six times more likely to become infected than boys, and they also are more likely to care for sick family members and drop out of school.

“We are losing decades of progress in girls education,” Ms. Thurman said.

Strong family structures in developing countries are absorbing most of the new orphans, but additional stress will rupture these safety nets.

Dr. Denzil Douglas, prime minister of St. Kitts and Nevis, said, “We are facing a crisis in our countries, and its impact is most felt in the lives of children infected and affected by the pandemic through no choice of their own.”

He made the comment while visiting La Casa Rosada, an orphanage in Santo Domingo, last weekend. Founded in 1993 by a former Miss World from the Dominican Republic, it cares for 43 HIV-positive children and is the only orphanage of its kind in the country, which has 33,000 orphans.

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