South Africa is neglecting most of the 100 000 children born here every year with HIV infection and half of them are likely to die before the age of 2, a senior U.N. official said on Tuesday.
"This is unacceptable," Ann Veneman, executive director of the United Nations Children's Fund (UNICEF), told Reuters in an interview. "The child really has been in some ways forgotten."
Although the country faces one of the world's heaviest HIV caseloads, Aids activists have accused the government of dragging its feet while the disease ravages millions of South Africans.
Veneman called on both the government and community leaders to end what she called a state of denial and to recognise the magnitude of the problem.
Very few get treatment
"They are missing so much. They are missing their parents because so many are orphans. They are missing teachers because so many are infected," she added.
Despite being amongst the most vulnerable of those infected, only a small proportion of children get adequate treatment - 10 to 15 percent. That, said Veneman, is a slight improvement on 5 percent two years ago, when UNICEF launched an initiative to "put the missing face of the child on the Aids pandemic".
"They are missing health-care workers. There are so many people that are impacted by this disease that children really have been the ones that are left out."
Alarming death rates
Veneman noted some progress on her four-day visit to South Africa, during which she discussed efforts to alleviate suffering with Nelson Mandela, who has his own Aids charity. She also met pregnant women and mothers infected with HIV/Aids.
She said death statistics were nevertheless still astonishing. An estimated 12 percent of South Africa's 47 million population have HIV.
"There are 500 000 new infections every year," including 100 000 children, said Veneman, adding, "There are 400 000 people who die every year."
Endorsing unproven treatments
South African officials, including President Thabo Mbeki, have infuriated AIDS activists by questioning accepted AIDS science and endorsing unproven treatments.
Health Minister Manto Tshabalala-Msimang has been dubbed "Dr Beetroot" for her promotion of beetroot, garlic and other foods as a treatment for HIV/Aids.
Veneman agreed the government should take a stronger, more vocal stand. But she said the problem cannot be tackled by the authorities alone. A new mindset was needed across South Africa, where HIV/Aids is still a taboo subject.
"I think it's very difficult if people don't stand up and speak about it. And I think that has to be done at every level of society, from local and community organisations to the top levels of government," she said.
A reluctant convert
The South African government was originally a reluctant convert to anti-retroviral medications (ARVs), which are credited with drastically reducing AIDS deaths. But Mbeki's government has since changed course, making ARVs a pillar of its plan to fight HIV/Aids.
It envisions a targeted five-fold increase in the number of HIV-positive people accessing ARVs by 2011 - but some 700 000 needy South Africans currently cannot get the medication.
"There is a ray of hope. But there are great challenges in terms of implementing plans and much needs to be done," said Veneman. – (Reuters Health)