Quality of life in developing countries HIVAids, and the poverty associated with it, is hitting children with a force no one foresaw, according to a new study prepared by UNICEF for the United Nations Special Session on Children in May 2002. In Africa, in particular, it has already undone the achievements in social development of the last half century. Life expectancy has fallen by between 18 and 23 years in the worst-affected countries; malnutrition has risen; immunization rates have dropped; more than 13 million children have been orphaned by Aids, 95% of them in Africa; and 4 million children have died of Aids since the epidemic began. Beyond Africa, in Asia, Eastern Europe and the Caribbean, decades of hard-won gains in child development and education are also unraveling. In all these places, where there is increasing poverty, sex is a currency and HIVAids has made it a deadly one. In Jamaica girls aged 15 to 19 are three times as likely to contract HIVAids as boys in the same age group. While deaths from traditional causes in under-fives are dropping, HIVAids has become the second leading cause of death in that age group. In the former Soviet Union ‘child poverty has sky-rocketed', accords to UNICEF. ‘Some 18 million of the region's 107 million people are living in poverty. A million and a half children are living in public care because their families are unable to provide for them. This is not what democracy and the market economy was supposed to bring.' The death of teachers, health workers and other social service staff from Aids is a vicious circle, ravaging services that are crucial to children's welfare and development. Thirty-six million people are living with HIVAids, and nearly 22 million have already died. But the stigma associated with Aids makes denial of the disease common. In Mozambique they call it ‘the century disease', and most death certificates for Aids patients bear the words ‘cause unknown'. Mozambique is typical of the countries where poverty and Aids form a vicious circle, with dramatic consequences for the next generation. Poverty results in sexually transmitted infections going untreated, magnifying 20-fold the risk of HIV transmission; poverty keeps children out of school; and lack of education multiplies the chances of girls selling sex as their only viable economic option. A report from the World Bank calls education ‘crucial to the reduction of world poverty' and promised £1bn new money to countries making progress. But it warned that the goal of getting all children into elementary school by 2015 was unlikely to be met by a quarter of the countries in Africa and South Asia. Poverty is also at the root of the exploitation of children, and another of the session's goals is to raise the awareness of their need for protection. Between 50 million and 60 million children do what the International Labor Organization considers ‘intolerable kinds of work'. A million a year are trapped in sex work; and 300,000 child soldiers fight in 30 wars. Other goals set in the previous ‘World Summit on Children' in 1990 are being reached, such as a drop in infant mortality by one-third in 63 countries; the eradication of polio and guinea-worm disease; a cut of 50% in the 470,000 deaths from neo-natal tetanus; the prevention of a million deaths from diarrhea and a Nat million child deaths from vitamin A deficiency; and the protection of 90 million newborns from loss of learning ability from iodine deficiency.

Question

1 Why might it help to supplement national income data with other indices of quality of life in such countries? What other indices might be used?

2 In what ways does HIVAids, and the poverty associated with it, make sustainable development all but impossible for such developing countries?

3 What types of policy interventions might help restore the possibilities of sustainable development?