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Children with AIDS in Africa

From a story by Sharon LaFraniere in the NY Times:

In Lesotho, as throughout much of sub-Saharan Africa, children with AIDS were generally considered a lost cause. Treatment, to the extent it existed, was limited to adults, for whom antiretroviral therapy is cheaper and easier. Now, that is slowly changing. Through some charitable foundations, pediatric AIDS medication is available for as little as $200 a year, half of what it used to cost and only $60 more a year than adult medication. Governments, international agencies and private charities have begun to train the region's ragtag health care corps to treat children. Still, only a few children get help. Death comes swiftly for those who go without. Half of all untreated H.I.V.-positive infants die before the age of 2 for lack of medication that can produce transformations seemingly overnight. With medicine, some American infants infected since birth have survived into adulthood and become parents themselves. Specialized and costly tests are needed to determine whether a child under 18 months is infected, although treatment can begin based on symptoms alone. Children are also more complicated to treat, partly because their medication must be constantly adjusted as their height and weight change. And pediatric drugs cost more than adult medication - until recently, up to three times as much. In Lesotho, a nation of 1.8 million encircled by South Africa, more than one in four adults is believed to be infected with H.I.V., the third highest infection rate in the world. Treatment for adults began only in November 2004. Treatment for children followed last April. Caseloads have been swelling ever since. But with an average of one doctor for every 20,000 people, patients sit shoulder-to-shoulder, sometimes waiting more than a day to be seen at a hospital. Health care workers continue to leave for better-paying work in South Africa, Britain or elsewhere. Lesotho officials have yet to treat AIDS like the national emergency it is, said Tim Rwabuhemba, Lesotho director for the United Nations AIDS agency. But other experts praise the government's determination to battle the epidemic, and foundations and charities are beginning to flock here. The World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria are pouring millions into the national budget for AIDS programs. The Clinton Foundation persuaded one pharmaceutical firm to halve its prices for pediatric AIDS medicines, and is donating the drugs to Lesotho and other nations.

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