AFRO-NETS> Kaiser Daily HIV/AIDS Report - Wed, 19 Sep 2001

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report - Wed, 19 Sep 2001 
------------------------------------------------
*HIV Surveillance Systems in Many Countries Are 'Poorly Functioning,' 
  Survey Shows
*South African AIDS Orphans Left 'Impoverished' and 'Unpro-
  tected'


HIV Surveillance Systems in Many Countries Are 'Poorly Functioning,' 
Survey Shows

Forty percent of the world's HIV/AIDS surveillance systems are 
"poorly functioning" or "non-existent", a UNAIDS survey team reports 
in the journal AIDS. Reuters Health reports that investigators led by 
Dr. Neff Walker of UNAIDS in Geneva, Switzerland, examined 167 sur-
veillance systems while compiling HIV/AIDS statistics at the end of 
1999. Forty-seven of the systems had been "fully implemented", 51 
were judged to be "good" and 69 were labelled "poor" or "non-
existent." However, there is "encouraging evidence that many of the 
countries worst affected by HIV have sound and functioning surveil-
lance systems that can be gradually expanded", the researchers said. 
The three overall weaknesses shared by most low ranking systems were 
a lack of surveillance among gay and bisexual men, "poor coverage" of 
rural populations and "inconsistency" in surveillance data over time. 
Most of the countries with poor or non-existent systems were in the 
Middle East and Northern Africa, while several countries in Eastern 
Europe, Central Asia and Latin America also had low-ranking systems. 
Countries were also ranked by epidemic level:  55 have HIV epidemics 
among the general population, 46 have "concentrated" epidemics among 
certain population groups and 53 have "low-level" epidemics. The 
United States has a concentrated epidemic and a fully operational 
surveillance system, according to the survey (Reuters Health, 9/17). 

South African AIDS Orphans Left 'Impoverished' and 'Unpro-
tected'

Approximately 420,000 children have been orphaned by AIDS in South 
Africa, and the number of households headed by under-age children 
continues to grow "at an alarming rate," according to a recent study 
by the Nelson Mandela Children's Fund, the Johannesburg 
Sowetan/allAfrica.com reports. Because of a "lack of resources or 
fear of stigma" of AIDS, NMCF Project Manager Richard Mkholo said, 
many relatives "shy away" from the orphans and "don't even bother to 
visit the distressed children". As a result, many children rely on 
community and church support, and many leave school due to poverty 
and lack of supervision. Mkholo said that the orphans "are being left 
outside the traditional society safety net. The extended family and 
community members appear largely unwilling to accommodate or feed an 
extra mouth." Subsequently, "the onus of care falls on those least 
capable of providing parenting and support, the siblings and the eld-
erly. They face the enormous challenge without income." The NMCF has 
recommended that extended families "be reorganized and given the ca-
pacity to absorb orphans" and has called for a review of social secu-
rity legislation to make "special provision for the swelling numbers 
of AIDS orphans" (Bhengu, Sowetan/allAfrica.com, 9/17). 

The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, 
a free service of The Henry J. Kaiser Family Foundation, by National 
Journal Group Inc. , 2001 by National Journal Group Inc. and Kaiser 
Family Foundation. All rights reserved.

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