Independent On-Line, 05 December 2002, Kids are parents to a million Aids orphans

Children are mothers and fathers to a million Aids orphans. This is one of the more heart-rending findings of a major study on HIV and Aids released on Thursday.

The report, funded by the Nelson Mandela Foundation and done by the Human Sciences Research Council (HSRC), found that 3,3 percent of households - an estimated one million people in 300 000 households - in
South Africa are headed by children under 18, and some as young as 8.

The study has not translated percentages into numbers, but the figures are estimated on the assumption there are 10 million households and at least four people in every home.

The report, the first systematically sampled national survey of HIV and Aids, has called on government to roll out the provision of antiretrovirals (ARVs) to people living with Aids as soon as possible.

It also urged government to take steps to reduce the price of drugs by removing VAT from medicines and encouraging the local manufacturing industry.

"
South Africa has the capacity to produce drugs to treat its people and even export them to the neighbouring countries," says the report.

It recommends wide-ranging steps to improve the treatment and prevention of the virus and to devote more resources to care facilities for people living with Aids.

Noting strong public support for the provision of ARVs, the report commends government for its April 17 statement on rolling out ARVs for HIV-positive mothers and the victims of sexual assaults and for significantly increasing state resources to counter the pandemic.

But it says the rollout of ARVs is just as urgent for all people living with Aids.

Mandela and the HSRC team briefed the presidency, the health department and other government stakeholders before the release of the report.

Government committed itself to a treatment programme for HIV-positive mothers and victims of sexual assault in April.

It later opened the door to the broader provision of ARVs at a cabinet meeting in October, when it announced that it had set up a joint committee of the treasury and the health department to determine the cost of providing ARVs.

Mandela unveiled the comprehensive study at the Sandton Convention Centre on Thursday, after launching a joint private sector-funded programme on Tuesday with the Medical Association of South Africa to provide about 9 000 public health sector patients with ARVs at 18 pilot sites.

Mandela's moves to push forward the HIV and Aids treatment, prevention and care programmes also coincides with a draft agreement reached last weekend between government, labour and business for a comprehensive plan to make drugs and treatment available to all people living with Aids.

The study - headed by former director-general of health and HSRC director Olive Shisana, and Leikness Simbayi, the HSRC's director of research - found that the prevalence of the virus has little to do with race and everything to do with socio-economic conditions.

While the report found that Africans aged 15 to 49 (18,4 percent) are much more susceptible to the virus than whites (6,2 percent), coloureds (6,6 percent) and Indians (1,8 percent), behavioural factors and living conditions are the
determining factor.

Significantly, a higher economic status did not protect affluent Africans from contracting the disease.

But Africans in overcrowded informal settlements in urban areas are twice as likely to contract the virus as those living in formal urban housing.

A surprise of the survey is the 6,2 percent infection rate for whites, representing about 275 000 people according to current population projections estimates based on the last census.

The report found that the highest prevalence rates are not in
KwaZulu-Natal, as previously thought, but that the Free State, Gauteng and Mpumalanga have the highest rates.

The
Western Cape, previously thought to have the lowest rate, is ahead of Limpopo, Northwest and the Eastern Cape.

The study found encouraging signs that young people are making major changes to their sexual behaviour through much higher use of condoms, reduction of sexual partners and making greater use of abstinence.

The government is expected to embrace the findings and recommendations as vindication of its policy since the turnaround of April 17.