Johannesburg — A NEW report on the effects of AIDS and poverty on children adds to the growing realisation that mistaken assumptions have rendered ineffective many of the world's attempts to help.

A meeting was held this month in London with international organisations to invite them to commit to specific actions recommended in the report, said Linda Richter, director of the Human Sciences Research Council's (HSRC's) Child, Youth, Family and Social Development unit.

These efforts would continue over the coming months with the African Union, other regional bodies, and through international conferences and other media, she said.

The report proposes tangible actions which are meant to shift the global AIDS response. The recommendations, targeted at governments and partners, if taken up, will contribute to the improvement of children's wellbeing and life chances, said Richter's HSRC colleague Vuyiswa Mathambo

The HSRC is part of the Joint Learning Initiative on Children and HIV/AIDS (JLICA), a global alliance of researchers, activists, policy makers and people living with HIV, which has used several forums to disseminate the findings of the two-year investigation that has produced the report.

More than 25 years into the AIDS pandemic, over 90% of the more than 2-million children living with HIV are infected before or during birth, and only a third of pregnant HIV-positive women in low- and middle-income countries receive the treatment they need to prevent them infecting their babies, according to the JLICA report, released yesterday .

Statistics also showed a small proportion of HIV-positive children received antiretroviral treatment and children in sub-Saharan Africa were significantly less likely to receive antiretrovirals than adults. Only 8% of children born to HIV-positive women were tested for the virus before they were two months old, meaning they lost their chance to benefit from treatment. Teenage girls in southern Africa were two to four-and-a-half times more likely to be infected than teenage boys, and an estimated 15m children alive today had lost one or both parents to AIDS, 12m of them in sub- Saharan Africa.

The JLICA claims significant gains are achievable if the world is willing to ditch those of its HIV/AIDS interventions that are based on misconceptions and adapt or develop its policies.

To help children vulnerable to HIV/AIDS means countries would have to develop their social protection schemes, provide benefits based on need and not on HIV status or orphanhood, reinforce families' ability to provide long-term care, strengthen community support systems, provide family-centred services integrating health, education and social support, redress the social and economic inequalities that increase girls' and women's vulnerability to HIV infection, and strengthen and act on the evidence for policies that work for children.

The JLICA said this new agenda would require "significant new resources" at a time when , because of the global financial crisis, mobilising for additional funding was difficult. "At the same time, strained economic conditions aggravate the hardships of those affected, and so increase the urgency of rapidly implementing the policies JLICA recommends. The very conditions that make policy action difficult also make it more imperative," the nongovernmental organisation (NGO) said.

One of the most destructive of the misconceptions that had thus far shaped policy on HIV/AIDS prevention and control was that only orphaned children were affected by the pandemic.

This had fed the "powerful myth" that the majority of children who had lost a parent to AIDS lacked family and social networks and needed to be cared for in an orphanage.

JLICA's research showed 88% of children designated as orphans actually had a surviving parent.

The NGO called on the United Nations to change its definition of an orphan as "a child who has lost one or both parents" because the definition had distorted programme goals by obscuring the fact that most of the children defined as AIDS orphans continued to receive support from their families or extended kin.

"The overwhelming majority of children who have lost a parent to AIDS can and should remain in the care of their families, provided that those families receive appropriate support," JLICA said in its report.

The NGO stated clearly that "poverty does not cause AIDS", although it added that extreme poverty was the backdrop to much of the AIDS pandemic and AIDS did cause and compound poverty.

"Over 60% of children in southern Africa live in poverty. Families who are already poor when HIV strikes may be unable to compensate for further loss of income that occurs as a result of AIDS-related illness or death. Poverty is the single biggest barrier to the scale-up of HIV treatment and prevention.

"Poor people's capacity to access and benefit from services is limited when they lack the resources to purchase food and medicines, pay for transport to service facilities and compensate for income that is sacrificed to healthcare," JLICA said.

Continuing its myth-busting mission, JLICA said focusing prevention campaigns on attempts to change behaviour overlooked the "harsh realities" of many children's and young people's lives.

The NGO said its research showed this type of focus was insufficient to protect teenage girls from HIV infection, because too many of them lived in situations in which they were extremely vulnerable to sexual harassment and abuse.

Instead, governments should put money into increased efforts to ensure girls' physical safety at school and work, on public transport and in places of recreation.

It was also important to tackle the "behaviours and attitudes that allow men to take sexual advantage of girls and young women with impunity", to keep girls in school and to improve their economic independence.

'Economic conditions aggravate the hardships of those affected, and increase the urgency of implementing policies'