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AIDS Remains a Leading Killer in South Africa


There's a different story on this World AIDS Day in South Africa, which has the world's highest number of AIDS cases. AIDS is not only the leading killer of South African adults, but also of younger children. NPR's Jason Beaubien reports from Cape Town.


AIDS now kills four times more infants in South Africa than any other disease or medical condition. A new report being released today by the University of Cape Town finds that HIV and AIDS remain the most common causes of death for children under the age of five in all parts of the country. Four years ago, South Africa put in place programs at public health clinics to try to prevent the transmission of HIV from mothers to their babies. Despite this, the rate of children being born with HIV has continued to increase. Maylene Shung-King is the deputy director of the Children's Institute at the University of Cape Town, which is releasing the new report.

Ms. MAYLENE SHUNG-KING (Children's Institute, University of Cape Town): Only a third of women that are supposed to access the prevention of mother to child transmission program are, in fact, accessing it.

BEAUBIEN: AIDS drugs can significantly reduce the chances that an HIV-positive woman will pass the virus on to her fetus or infect her baby while giving birth, but Sung-King says pregnant women aren't getting tested early enough, and even if they do find out that they're infected, the public health system, particularly in poor rural areas isn't treating them effectively. The broader societal effects of HIV on children go beyond just driving up mortality rates. In her new report on the state of the nation's children, Shung-King says that HIV is the issue that now has the most profound effect on South African children's lives, and not just for kids who are infected with HIV.

Ms. SHUNG-KING: There are vast numbers of children that are affected by HIV that live within households and communities where adults are sick and dying of HIV. I think, you know, from all points of view it is at the moment the biggest health and social and economic crisis that the country is facing.

BEAUBIEN: Southern Africa has the highest rates of HIV in the world. In parts of South Africa, Swaziland and Zimbabwe, almost 40 percent of adults are believed to be carrying the virus, and in turn large numbers of babies are being born with HIV or they contract it from breast-feeding. In the year 2000, Botswana reported that 60 percent of infant deaths were AIDS related. With so much of the focus of HIV prevention being on condoms and abstinence and adult sexuality, Sarah Crowe with UNICEF says the issue of protecting children from the virus has often been overlooked.

Ms. SARAH CROWE (UNICEF): I think up until now, AIDS has really been seen as an adult disease, and children have been somewhat neglected.

BEAUBIEN: According to UNICEF, less than 10 percent of HIV-positive women in Africa are getting access to treatment that could shield their babies from the virus, and Crowe says once children are infected, they're much less likely than adults to get on life-prolonging drugs.

Ms. CROWE: Countries that have really got a good program, such as Botswana, Mozambique, they're reaching between 1 and 10 percent, maximum 10 percent of the children who should be on treatment.

BEAUBIEN: More than three and a half million African children have already died from HIV and AIDS, millions more are now orphans, and each day hundreds of new babies are born infected with the virus.

Jason Beaubien, NPR News, Cape Town.

INSKEEP: This is NPR News. Transcript provided by NPR, Copyright NPR.

Jason Beaubien is NPR's Global Health and Development Correspondent on the Science Desk.