LETTER TO EDITOR
|Year : 2008 | Volume
| Issue : 1 | Page : 47-48
AIDS orphans: An ignored issue in India
Harshal T Pandve, JS Bhawalkar, PA Bhuyar
Department of Community Medicine, Dr. D.Y. Patil Medical College, Pimpri, Pune, India
Harshal T Pandve
Department of Community Medicine, Dr. D.Y. Patil Medical College, Pimpri, Pune - 411018
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pandve HT, Bhawalkar J S, Bhuyar P A. AIDS orphans: An ignored issue in India. Indian J Sex Transm Dis 2008;29:47-8
In India, as elsewhere, AIDS is often seen as "someone else's problem" - as something that affects people living on the margins of society, whose lifestyles are considered immoral. Even as it moves into the general population, the HIV epidemic is misunderstood and stigmatized among the Indian public. People living with HIV have faced violent attacks; been rejected by families, spouses, and communities; been refused medical treatment; and even, in some reported cases, denied the last rites before they die. 
Another emerging as well as highly ignored issue about HIV/AIDS is children orphaned by the disease. Children orphaned by AIDS are those under the age of 18 who have lost one or both parents to the disease. Today, India is a home to the largest number of AIDS orphans in the world (the UN estimates). India is expected to become the next epicenter of the AIDS orphan crisis. Though there are no government figures in the country for the number of children affected by AIDS, World Bank estimates suggest that the number of children in India orphaned by AIDS is approaching 2 million. The proportion of orphaned children is expected to double by 2010 years and remain exceptionally high until 2020 or 2030.  Issue of AIDS orphans is another ugly face of the killer disease.
Stigmatized through no fault of theirs, these AIDS orphan children are far more vulnerable to abuse and exploitation.  Children, whose parents have AIDS and/or die with AIDS, are impacted medically, socially, and economically.  AIDS orphans excluded, discriminated, against and left to fend for themselves, they are psychologically distressed, and they do not have access to basic education and basic health care. Due to lack of support and care, they are at higher risk of bad health and nutritional problems. They are easy prey to all forms of exploitation like prostitution, beggary, juvenile delinquency, and drug abuse.
A number of recommendations have been made to address this growing problem. A number of sub-Saharan African countries have changed laws and child welfare systems.  Intervention options for providing care and support to orphans in India are limited. India has little experience with community-based care and institutional care is often relied upon as the most common form of intervention. However, even the number of orphanages providing short-term care for AIDS orphans is insufficient. The Indian Government has been criticized for clinging to the idea that the epidemic is limited to the 'high-risk groups' like sex workers, drug users, and truck drivers. But this approach no longer reflects the reality of at least some Indian states, where the epidemic is in the general population.  Eighty percent of AIDS funding goes toward prevention in the high-risk populations and only 20% to caring for children and families living with HIV. 
India's ambitious National AIDS Control Programme is in its third phase. Government of India also initiated Antiretroviral Treatment Programme in high prevalence states. But AIDS control policy is lacking in any specific provisions related to the AIDS orphans in country. India needs to develop a policy for AIDS orphans for their treatment as well for the rehabilitation and welfare. Sub-Saharan countries are good example to follow about their work for AIDS orphans. Fundamental steps in building a supportive environment include involving children and families affected by HIV/AIDS in care and treatment strategies; increasing awareness of the impact of HIV/AIDS on children and families; and reducing fear, ignorance, denial and discrimination by increasing access to information, challenging myths and transforming the public perception about HIV/AIDS.  These innocent children need support and care and as a nation, as a community, and as an individual it's our duty to give them what they really required.
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