Photo: UNAIDS/A.Gutman

One-third of HIV-infected children are “slow progressors” with an average life expectancy of 16 years

JOHANNESBURG,  – The number of HIV-infected children in southern Africa who survive into adolescence without treatment is greater than previously thought, and will keep increasing for years to come.

These are the findings of a study estimating the scale and likely course of the HIV epidemic among older children in southern Africa, published in the September 24 issue of AIDS, the journal of the International AIDS Society.

Previously, it was assumed that few children who contracted HIV from their mothers would survive beyond the age of five without antiretroviral (ARV) treatment, but Prof Robin Wood, director of the Desmond Tutu HIV Centre at the University of Cape Town and one of the co-authors of the study, noticed unexpectedly high rates of HIV infection among older children in large sets of prevalence data he was analyzing.

“I was surprised; my first assumption was that there was some sexual molestation going on here, but when I looked more closely I saw that the number was increasing as every year went by, and it was equally distributed among males and females,” he told IRIN/PlusNews. “Then we talked to people in Zimbabwe who’d seen the same thing and we decided to put together a model.”

Most HIV-prevalence surveys exclude children aged between five and 15, but recent surveys in Zimbabwe, Botswana, South Africa and Swaziland included them.

The authors compared figures from these surveys with data on mother-to-child transmission (MTCT) and child survival to make projections about the prevalence of HIV among older children in South Africa and Zimbabwe over the next 20 years. They estimated that about one-third of HIV-infected infants in Africa were “slow progressors”, with an average life expectancy of 16 years.

No one knows precisely why some children succumb rapidly to AIDS-related illnesses and others much more slowly, but the authors of the study published in AIDS speculated that infants infected post-natally, through breast feeding, were more likely to be slow progressors than those infected during pregnancy or delivery.

Few children aged between five and 15 are tested for HIV, as most healthcare providers are unaware that some infected children can survive for many years. As a result, there is often a significant time lag before slow progressors are diagnosed.

The growing number of HIV-infected older children now being diagnosed in South Africa is the result of high rates of MTCT 10 years ago. “It highlights the fact that if we don’t get on top of MTCT now, we’ll be seeing the consequences of it for decades afterwards,” Wood said.

In Zimbabwe, where adult HIV prevalence peaked in the late 1990s but has since declined, the infection rate among 10-year-olds is expected to fall from 3.2 percent in 2008 to 1.6 percent in 2020.

In South Africa, HIV prevalence among 10-year-olds is expected to increase from 2.1 percent in 2008 to 3.3 percent in 2020 if prevention of MTCT is not provided.

Wood warned that health care providers in South Africa should be prepared to deal with rising numbers of HIV-infected adolescents – not only slow progressors, but also those who have been on ARV treatment since infancy, and those who have contracted HIV through sex.

“They’re a tricky group to deal with for many reasons – adherence to therapy is not as good as in younger children,” he said. “They have special needs and we need to design more adolescent-friendly clinics for them.” The Desmond Tutu HIV Foundation has set up one such clinic in Gugulethu, a township outside Cape Town.

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Photo: Peter Martell/IRIN

Senior Sudanese officials (file photo): Sudan’s future beyond the April 2010 elections and a referendum on southern autonomy the following year is uncertain, says a report

NAIROBI, – Sudan is planning to hold elections in April 2010 and a referendum on southern autonomy the following year, but beyond this the future is uncertain, says a report entitled “Sudan 2012 – Scenarios for the Future”.

The report is based on a study by Jaïr van der Lijn of the Netherland Institute of International Relations and commissioned by IKV Pax Christi and Cordaid.

Two key uncertainties will define possible scenarios in 2012 – will Sudan be united or will the North and South have gone separate ways? Or will there be a new war between the North and the South, or will there be no war?

“At present, the international community, governments, international organizations and civil society groups are primarily focused on stimulating implementation of the Comprehensive Peace Agreement and making sure an election and referendum take place…little time is given to thinking strategically about the period after 2011. What will happen in 2012 is barely touched on,” the report says.

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Photo: Manoocher Deghati/IRIN

Many Afghans fear suicide bombers may not feel constrained by International Peace Day (file photo)

KABUL,- Taliban insurgents have called the UN-initiated International Peace Day, 21 September, “a futile showy day” but said their fighters will be in a defensive position on the day.

The UN and aid agencies have called on all warring parties in Afghanistan to respect a day of tranquillity on 21 September, which is also Eid-ul-Fitr, and allow aid workers to deliver essential supplies in insecure parts of the country.

“Stop the fighting on 21 September and demonstrate that there is a readiness from all of us to move into a peace process,” said Kai Eide, the UN special representative in Afghanistan.

“We Afghans, more than any other nation in the world, realize the value of peace… I order every member of the Afghan armed forces not to resort to force on this day, except when attacked,” said a statement issued by President Hamid Karzai’s office on 16 September.

However, the insurgents have not unreservedly supported a day of ceasefire.

“The government and the UN only make futile statements… We did not start this war; it was imposed on us,” Qari Yusuf Ahmadi, a purported Taliban spokesman, told IRIN on the phone from an unidentified location. “Our forces will remain in defensive position, as usual.”

The UN Assistance Mission in Afghanistan (UNAMA) said the Peace Day was more than mere symbolism, and reflected an overwhelming demand among Afghans for peace.

“Afghan people cannot afford this any more… We need peace now. We need to bring this terrible conflict to an end,” said Eide.

Established by a UN resolution in 1982, Peace Day has been marked across the world as a day free of violence and gunfire.

Suicide attackers

Attacks have continued in the run-up to Peace Day. The insurgents reportedly claimed responsibility for a spectacular suicide attack on a convoy of Italian forces in Kabul on 17 September, killing and wounding several people.

“We cannot control and stop our martyr [suicide] attackers,” said Taliban spokesman Ahmadi, implying there could be more suicide attacks in the coming days.

Insurgent tactics – particularly the use of suicide attacks and improvised explosive devices – have caused considerable and increasing civilian casualties, according to UNAMA and other experts.

Armed violence has increased significantly across Afghanistan over the past few years and insurgent groups have established a presence in large swathes of the country, the International Council on Security and Development said in a report on 10 September.

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Photo: Manoocher Deghati/IRIN

UN Secretary-General Ban Ki-moon

NAIROBI,  – AIDS activists around the world have welcomed a new UN General Assembly resolution to create a single agency to promote the rights and wellbeing of women, which they say is good news for women, who are bearing the brunt of the global AIDS pandemic.

“This is a historic opportunity to advance the rights of women and girls,” said UNAIDS executive director Michel Sidibé in a statement.

Under the new resolution, four UN agencies dealing with women’s issues – the UN Development Fund for Women (UNIFEM), the Division for the Advancement of Women, the Office of the Special Adviser on Gender Issues, and the UN International Research and Training Institute for the Advancement of Women (UN-INSTRAW) – will be merged to form a new, consolidated body headed by an under-secretary general.

Some activists say the move is long overdue, calling the UN’s response to women’s issues so far a “lamentable failure”.

“Thirteen years after UNAIDS was established, and even with the subsequent horrendous toll of the pandemic on women and global recognition of the feminization of AIDS, there is no organization representing women on the committee that steers UNAIDS’ work,” said a statement by AIDS-Free World, an international NGO that advocates a more effective global response to HIV. “What better example is there of the UN’s dismissal of women?”

Women hit hardest

Women make up 60 percent of people living with AIDS in sub-Saharan Africa, a figure that rises to 75 percent in the 15-24 age range. In Asia, nearly 50 million women are at risk of becoming infected with HIV from their partners.

“We don’t see the UN’s presence – beyond the policy level – supporting networks on the ground, deep in the villages where women and children affected by HIV have very poor access to health care,” Marion Natukunda, project director for the grass-roots Ugandan NGO, Mamas Club, told IRIN/PlusNews.

“We hope the new agency will help with advocacy around women’s issues, and will lead to more grass-roots support for HIV-positive women,” she added.

AIDS-Free World urged UN Secretary-General Ban Ki-moon to reserve a seat for the head of the women’s agency on the Committee of Co-sponsoring Organizations that comprise UNAIDS.

“We see this not as an end but a beginning – the UN’s first attempt to form a serious gender entity, and the Secretary-General’s opportunity to make a monumental change both in the way the UN operates, and in the lives of women everywhere,” said Stephen Lewis, co-director of AIDS-Free World and former UN special envoy for HIV/AIDS in Africa.

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Photo: Adel Yayha/IRIN

Ahmad al-Asa with his children in al-Khaiwan School, used as a camp for IDPs in Amran Province

DUBAI,  – The director of the UN Office for the Coordination of Humanitarian Affairs (OCHA) in New York, Rashid Khalikov, has described the situation in northern Yemen as a neglected humanitarian emergency, and urged the international community to bolster its support.

“Despite the deep vulnerability of the tens of thousands people who have fled from conflict in northern Yemen, this humanitarian emergency has been largely neglected by the entire international community outside of Yemen, and also by the media,” Khalikov said in a statement on 16 September.

A $27.5 million flash appeal for Yemen on 2 September had received zero funding by 17 September, according to OCHA’s Financial Tracking Service.

UN World Food Programme Executive Director Josette Sheeran said food aid had begun to be distributed in Saada town on 14 September “despite all odds and extremely tense security conditions”.

at/cb Theme(s): (IRIN) Aid Policy, (IRIN) Conflict, (IRIN) In Brief, (IRIN) Refugees/IDPs

Photo: UNHCR/K.McKinsey

Small fishing boats, like this one in Bossaso’s busy commercial port, carry up to 125 people when used to smuggle migrants from the Somali coast across the Gulf of Aden to Yemen

SANAA, 17 September 2009 (IRIN) – At least 16 Africans died, and 49 others are missing and presumed dead, in three separate incidents as boats smuggling them from Somalia to Yemen capsized in the Gulf of Aden on 13 and 14 September, according to the UN Refugee Agency (UNHCR).

Ahmad Akam, a Yemeni coast guard official, said the people smuggling season had just started. “It usually begins in September every year as the weather becomes milder, helping smugglers traffic Africans to Yemen by boat.”

He said each passenger paid smugglers about US$50 to get from the Somali port city of Bossaso to Yemen.

On 13 September a boat carrying 142 Somali and non-Somali citizens had engine failure and capsized near the Yemeni coastal town of Radfan, 150km east of the UNHCR-run Mayfaa Reception Centre for Somali refugees, according to Leen al-Mugahed, a public information assistant at UNHCR’s Sanaa office.

“Ninety-eight passengers managed to swim ashore while 43 others are still missing and presumed dead,” she said. Survivors said one person had died of suffocation in the boat’s engine room.

In another incident, a boat carrying 122 Africans capsized near Yemen’s shores and 13 passengers lost their lives because of severe mistreatment at the hands of smugglers, said a 15 September statement by UNHCR. It quoted survivors as saying the dead passengers had been accommodated in the boat’s engine room since departing from the Somali village of Marera.

Photo: Adel Yahya/IRIN

After arriving in Yemen and registering as refugees, many Somalis live in difficult conditions

A third incident was reported by a European Union warship, the Louise of Belgium, which detected a sinking boat. The warship proceeded immediately to the scene and rescued 38 people.

UNHCR quoted survivors as saying there were originally 48 people on board. Two dead bodies were spotted by navy helicopters engaged in the rescue but were not recovered as priority was given to survivors. Agency officials said another six passengers were missing and presumed dead.

3,000 new arrivals in September

Rocco Nuri, external relations officer at UNHCR’s Aden office, told IRIN on 16 September there were a total of five boats trafficking refugees and economic migrants from the Horn of Africa to Yemen when the incidents occurred.

About 3,000 Africans have fled to Yemen since 1 September, he said.

“The influx of new arrivals from the Horn of Africa is likely to continue due to a number of push factors which are forcing people to flee Somalia and neighbouring countries, such as ongoing conflict, political instability, famine and extreme poverty,” Nuri told IRIN.

Yemen is one of the poorest countries in the Middle East, with scarce resources and limited employment opportunities, yet it hosts over 140,000 refugees and grants refugee status to all Somalis entering its territory, according to UNHCR.

Since the beginning of 2009, 860 boats carrying 43,586 people have made the perilous journey to Yemen across the Gulf of Aden; 273 people have died or are missing and presumed dead, according to UNHCR.

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