The Next AIDS Generation: Orphans in Asia and the World

AIDS orphans lie in beds made from hanging mosquito nets. (© Masaru Goto / World Bank))


May 12, 2004

David Gartner, Policy Director, Global AIDS Alliance; Peter McDermott, Chief, Global HIV/AIDS Programme, UNICEF; Sara Sievers, Director, Orphans Initiative, Association François-Xavier Bagnoud; Chung To, Founder and Chairperson, Chi Heng Foundation; Steven Wang, Founder and President, China AIDS Orphan Fund

Welcome remarks and moderated by Nafis Sadik, UN Special Envoy for HIV/AIDS in Asia and the Pacific

On May 12th 2004, the Asia Society and the U.S. Fund for UNICEF hosted the panel discussion, The Next AIDS Generation: Orphans in Asia and the World. Held at the Asia Society, the program convened leading experts from the field to explore the challenges facing children orphaned by AIDS as well as current and still needed responses the crisis.

Peter McDermott offered a global overview of the severe situation of AIDS orphans but warned that the worst is yet to come. Mr. McDermott urged focus on the children in Asia, the region that will host the pandemic’s ‘Third Wave, and pointed out that the AIDS pandemic targets youth. Specific economic, social, and biological determinants will help to predict which regions and societies will be hardest hit. Although Asia has always had a large orphans population, the population was on a general decline until HIV/AIDS took hold. Now, this positive development has been undermined and we must wait to see whether the infrastructure in Asian countries can withstand the shock of this population that suffers extreme psychosocial impact, malnutrition, and reduced access to education and healthcare. Although Peter McDermott and others have developed a consensus—such as the Millennium Development Goals—and models around necessary responses and many strides have recently been made in Asia in governmental involvement and coordination, much more is needed.

Sara Siever’s presentation, entitled, Orphan Care: a Rights-Based Approach, emphasized that it is every child’s inherent right that his or her needs be met. The Convention of the Rights of Child, which more than 190 countries have already signed—United States has not—legalizes this assumption, which is currently not being met for millions of children. Association François-Xavier Bagnoud’s programs are characterized by this belief. The Barber Intervention and tele-counseling programs in India underscore the Association’s focus on understanding the communities in which it works and adapting its efforts to the specific needs and attributes of those communities.

Dr. Steven Wang, MD, related his story of growing personal involvement in the welfare of AIDS orphans in China, especially Henan province. After reading Elizabeth Rosenthal’s article on AIDS in rural China that was featured in the New York Times, Dr. Wang and others were moved to establish the China AIDS Orphan Fund in March, 2003. Working out of Minneapolis and partnering with other local and international organizations, CAOF has raised and delivered funds to Chung To’s Chi Heng Foundation to pay for children’s school fees. Dr. Wang stressed the need for networks among similar organizations in order to more quickly and with greater confidence identify transparent organizations in China and the United States. The absence of this network has translated into the delay of fund deliveries as well as the spending of extra time, money, and energy.

Chung To described the extent of HIV/AIDS in Henan province due to unsanitary blood collection in the 1990s. By sharing stories of personal interactions with the sick and their families, Mr. To animated the extent of human suffering and the deterioration of communities that has reinforced his personal commitment to providing AIDS orphans access to education. As the middle generation in many communities was wiped out, Mr. To has noticed the transformation of the family structure: grandparents or the eldest child often take over in caring and providing for the younger children. Currently paying for the education of over 1,200 children, Mr. To is concerned that if these children are not schooled, they will place devastating and increasing burdens on China’s infrastructures. Chung To also decided to work with children because sponsoring their education is not very politically sensitive in China—a country that has only recently admitted to having a crisis.

After calling the AIDS crisis the moral crisis of our time, David Gartner explained that the orphans crisis is the natural extension and stepchild of the AIDS crisis. However, Mr. Gartner argued that there is reason for hope. The emergence of political will around AIDS, the decrease in the price of medicines, and the creation of new mechanisms and models to respond to the crisis are important recent achievements. The orphan crisis must experience the same kind of growth in political strength. Even so, there is currently reason for hope: Mr. Gartner described the political momentum building around the crisis, exemplified most recently in the Assistance for Orphans and Vulnerable Children Act, which is currently before Congress. Mr. Gartner also stressed the need for orphan prevention and cited the Global Fund to Fight AIDS, Tuberculosis, and Malaria as an integral collaborative effort in tackling AIDS infection. New initiatives to eradicate school fees in some countries and to provide treatment to HIV positive children—as Keep a Child Alive does—all give reason for hope. Mr. Gartner called on audience members and all persons to get involved in order to build on this momentum.

During the question and answer period, panelists discussed medical issues such as breastfeeding and mother-to-child infection and the role of unsanitary medical practices in HIV/AIDS prevalence. Panelists also discussed the potential correlation between strong moral codes and pervasive religion in certain communities and low HIV/AIDS prevalence. Chung To described how local governments in Henan province received him and panelists discussed the need for, and advancements in, coalition building around the AIDS orphan crisis.