Fewer orphans globally, due to HIV medication provided by the U.S. : NPR
Until last year, the number of children orphaned because a parent died of AIDS was plummeting. It’s thanks to America’s 20-year effort to provide life-saving HIV medications to millions of people in need. But last year’s upheaval in foreign aid funding has raised fears that more children are at risk of losing a parent to the deadly virus.
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In the early 2000s, the United States began investing millions, if not billions, of dollars in the fight against AIDS around the world. This effort has saved more than 25 million lives, largely through the distribution of life-saving medicines. NPR’s Jonathan Lambert reports on new research showing another benefit of these HIV drugs: a dramatic reduction in the number of orphans.
JONATHAN LAMBERT, BYLINE: Early in Uganda’s HIV epidemic, Dr. David Serwadda traveled to Rakai district in the rural south to investigate some of the first cases. As the epidemic grew in the late 1980s and early 1990s, the consequences were severe.
DAVID SERWADDA: You can walk around the houses and you just have graves around the house. There were households in Rakai that were actually headed by orphans.
LAMBERT: Serwadda remembers visiting what looked like an abandoned house in 1993.
SERWADDA: We kept shouting: is anyone home? And then a young boy of 9 years old and two children aged 6 and 7 came out. We asked where – you know, where are the parents? The parents had left.
LAMBERT: It’s probably because they died of AIDS. If you were a child whose mother was infected at the time, you were 20 times more likely to be an orphan. These orphans face stigma, higher rates of school dropouts, and mental health issues. Many found themselves in poverty.
SERWADDA: Some children found themselves without parents or guardians to take care of them. It was heartbreaking.
LAMBERT: Today, the situation has improved a lot. The risk of children being orphaned by HIV has fallen. That’s according to a new study published in The Lancet Global Health by Serwadda and colleagues. The reason? – life-saving anti-HIV drugs, called antiretrovirals, provided primarily by U.S. foreign aid.
SERWADDA: I’m about 70 years old now. In public health, I have never seen an intervention program that has had such a huge impact.
LAMBERT: It seems obvious that giving parents with HIV life-saving drugs would mean fewer orphans. But to understand how much of a difference it made, the team analyzed data on births, deaths and HIV status among households in Rakai district from 1995 to 2002. They found that the number of orphans declined dramatically, from about 21 percent of children to just 6 percent. Rachel Kidman is an epidemiologist at Stony Brook. She did not participate in the study.
RACHEL KIDMAN: The results are so clear. This decrease in the number of orphans is absolutely due to adults having access to life-saving antiretroviral drugs.
LAMBERT: Continued access to these drugs is now in question after the Trump administration’s drastic foreign aid cuts. Last year, many Ugandans were unable to get their HIV medications, which they must take daily, because the health workers who dispensed them lost funding. Kidman fears this could mean more HIV orphans.
KIDMAN: And I think the consequences for children are going to be very dire.
LAMBERT: In a statement, the State Department told NPR that the United States continues to provide lifesaving treatment to people living with HIV. David Serwadda says it is true that partial funding has resumed for many programs.
SERWADDA: But some programs simply never got off the ground.
LAMBERT: Over the next five years, the United States plans to transfer responsibility for these programs to Uganda. This transition will pose a significant challenge for the country, especially after the damage caused to health systems by budget cuts last year. But Serwadda thinks their study reveals what’s at stake: Future generations of children depend on their success. Jonathan Lambert, NPR News.
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