Protecting Childhood in the AIDS Pandemic

Finding Solutions that Work

Edited by Jody Heymann, Lorraine Sherr, and Rachel Kidman

Brings together state-of-the-art perspectives on children within the HIV pandemic in a single volume
Each chapter synthesizes available evidence and presents recommendations for practice
Provides a framework for readers committed to reaching children in times of crisis

Protecting Childhood in the AIDS Pandemic

Finding Solutions that Work

Edited by Jody Heymann, Lorraine Sherr, and Rachel Kidman

Description

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 HIV/AIDS falls heavily on extended families who support HIV-infected family members, care for relatives who are sick and dying, and for children who are left behind. Adults who take on these caregiving burdens have less time for their own children, fewer financial resources, and often face greater difficulties meeting even basic needs. 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 global experts 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 around the world.

Protecting Childhood in the AIDS Pandemic

Finding Solutions that Work

Edited by Jody Heymann, Lorraine Sherr, and Rachel Kidman

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. 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-aged Children
Xiaoming Li and Yan Guo

6. Healthy Minds: Psychosocial Interventions for School-aged Children Affected by HIV/AIDS
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 M. 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 Directed Toward AIDS-affected Children or Poor Families?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 Not to Turn Away
Chris Desmond

Protecting Childhood in the AIDS Pandemic

Finding Solutions that Work

Edited by Jody Heymann, Lorraine Sherr, and Rachel Kidman

Author Information

Jody Heymann, MD, PhD, is the Founding Director of the Institute for Health and Social Policy at McGill University. She led some of the earliest work on preventing post-natal HIV transmission, reducing HIV associated tuberculosis, and improving ways to get HIV treatment to low-income settings. An internationally renowned researcher on public policy and equity in 190 countries, Heymann's work has been featured widely in The New York Times, Washington Post,CNN, NPR, Financial Times, and Business Week, 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.

Contributors:

Michelle Adato, PhD
Director of Social and Gender Assessment
Millennium Challenge Corporation

Simona Bignami, PhD
Assistant Professor of Social Statistics
Université de Montréal, Canada

Agnes Binagwaho, MD
Permanent Secretary of the Ministry of Health
Republic of Rwanda

Mark E. Boyes, PhD
Postdoctoral Research Officer of Social Policy and Intervention
University of Oxford, and
Junior Research Fellow
Wolfson College

Kevin Clarke, MD
Pediatrician
South to South Program
Zambia, Malawi and South Africa

Janine Clayton, PhD
Psychosocial Support Technical Advisor
University of Stellenbosch, South Africa

Lucie Cluver, PhD
Lecturer
Oxford University, and
Honorary Lecturer
University of Cape Town, South Africa

Mark Cotton, MD, PhD
Senior Specialist and Professor of Paediatrics and Child Health
Stellenbosch University and Tygerberg Children's Hospital, South Africa

Hoosen Coovadia, MD
Director of Maternal and Child Health
University of the Witwaterstrand, and
Emeritus Professor in Paediatrics and Child Health and HIV/AIDS Research
University of KwaZulu-Natal, South Africa

Chris Desmond, PhD
Research Associate
François-Xavier Bagnoud Centre for Health and Human Rights
Harvard University

Angela Dramowski, FCPaed, MBChB
Fellow in Paediatric Infectious Diseases
Stellenbosch University and Tygerberg Children's Hospital, South Africa

Patrice Engle, PhD
Professor of Psychology and Child Development
California Polytechnic State University

Geoff Foster, MD
Pediatrician
Ministry of Health
Mutare, Zimbabwe

Stefan Germann, PhD
Director for External Partnerships, Research and Learning for Health, HIV and Nutrition
World Vision International

Yan Guo, PhD
Post-doctoral Research Fellow
Pediatric Prevention Research Center
Wayne State University School of Medicine

Jody Heymann, MD, PhD
Founding Director
Institute for Health and Social Policy, and
Canada Research Chair in Global Health and Social Policy
McGill University

Stuart Kean, PhD
Senior HIV and AIDS Policy Adviser
World Vision International

Malega Constance Kganakga, PhD
Chief Director of the HIV/AIDS Division
National Department of Social Development, South Africa

Rachel Kidman, PhD
Research Assistant Professor
Tulane University School of Public Health and Tropical Medicine

Xiaoming Li, PhD
Professor and Director of Pediatric Prevention Research Center
Wayne State University School of Medicine

Vinod Mishra, PhD
Chief of the Population Policy Section
Population Division, United Nations Population Division

Happyson Musvosvi, MD, MPH
Clinical Advisor
South to South Program

Marie-Louise Newell, PhD
Professor of Pediatric Epidemiology
University College Institute of Child Health, London, and
Professor of Health and Population Studies
University of KwaZulu-Natal, South Africa

Nathan Nshakira MD
Associate Lecturer in Public Health
Uganda Christian University, Mukono, Uganda

MiHyung Park, MPH
Regional Program Development and Evaluation Officer for Asia
Samaritan's Purse

Linda Richter, PhD
Distinguished Research Fellow
Human Sciences Research Council, South Africa, and
Honorary Professor of Paediatrics
University of the Witwatersrand, South Africa, and
Honorary Fellow of Psychiatry
University of Oxford

Marina Rifkin, MHS
Program Monitoring Advisor
South to South Program

Rachel Samuel, PhD
Director
Sustainable Health and Development Solutions, United Kingdom

Annemadelein Scherer
Neuro-Developmental Advisor
South to South Program

Lorraine Sherr, PhD
Clinical psychologist, and
Professor in Clinical Health Psychology
Royal Free and University College Medical School

Amy Slogrove, PhD
Paediatric Clinical Advisor
South to South Program

Liezl Smit, MD
Clinical Program Director
South to South Program

Nigel Taylor
Coordinator
Friends of Treatment Action, United Kingdom

Douglas Webb, PhD
Social Scientist
UNICEF, Ethiopia

Protecting Childhood in the AIDS Pandemic

Finding Solutions that Work

Edited by Jody Heymann, Lorraine Sherr, and Rachel Kidman

Reviews and Awards

"AIDS has shattered the lives of millions of children around the world. Government officials, churches, and international donors have not always agreed about what to do to help them. This incredibly important volume, which brings together the views and deep experience of some of the most important scholars in the field, should give them invaluable guidance." -- Helen Epstein, PhD, author of The Invisible Cure: Why We are Losing the Fight Against AIDS in Africa

"Heymann, Sher, and Kidman are influential leaders in global public health and they make a compelling argument for an integrated and comprehensive approach to transform outcomes for children affected by HIV. Anyone concerned about the enormous impact of HIV/AIDS on children should study their arguments carefully and build programs based on the principles clearly outlined in this important new volume." -- Jim Yong Kim, MD, PhD, President, Dartmouth College

"The statistics are shocking: an estimated 17 million children have lost a parent to AIDS, a further 2.5 million are currently living with the virus. Yet, the statistics mask the realities for these children-the repeated loss of family members to the disease, the stigma, the poverty. This book is a timely examination of the daily reality of children affected by AIDS, shedding light on this much neglected and tragic outcome of the AIDS epidemic, giving us new perspectives of how best these children can be supported." -- Peter Piot, MD, PhD, Director, London School of Hygiene and Tropical Medicine, and former Executive Director, UNAIDS

"The chapter authors are experts from sub-Saharan Africa, Europe, South Asia, Australia, and Central and North America and come from diverse professional backgrounds. The examples of working programs in multiple countries are a plus. " -- JAMA

"Overall, the book is very informative and provides extensive notes (references) for the reader. Its major strengths are in its international scope, where key topics are discussed by authors from across multiple nations and multiple professional areas. The book presents comprehensive descriptions of the issues and risks (health, developmental, psychological, and behavioral) inherent to children with HIV/AIDS. This book is particularly recommended to readers who are not familiar with pediatric HIV and would like to expand their knowledge on this subject." -- Ram Yogev, Northwestern University University Feinberg School of Medicine, and Ann and Robert H. Lurie Children's Hospital of Chicago, Illinois, Clinical Infectious Diseases