Debate

Meeting Children's Needs in a World with HIV/AIDS:
An International Symposium

"Can a developing country support the welfare needs of children affected by AIDS?"

Key Questions:

1. How much will it cost to realize the rights of children affected by HIV/AIDS?
2. Where will the money come from and how should it be allocated?
3. Can expenditures to protect affected children’s rights and wellbeing be made to fit in with affected governments' other spending priorities?

Follow and contribute to the debate on the JLICA blog.

Or you can email your comments to jlicalg4@ssrc.org

Initial Debate Papers

Francisco Bastos, Amy Nunn.
According to UNAIDS, 40 million people live with HIV/AIDS globally. Over 95% of the new AIDS cases in recent years have been registered in developing countries. Though the epidemic is largely concentrated in Sub-Saharan Africa, it is also growing quickly in the most populous countries in Asia. As Anthony Fauci, Director of the United States National Institute of Allergy and Infectious Diseases, recently remarked at the 2007 Sydney AIDS Conference, though remarkable progress has been made in scaling up treatment, and two million people currently receive drugs for AIDS treatment, for each person receiving treatment, six new people are infected.

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Chris Desmond.
Families, communities, faith-based organisations and non–governmental organisations do support the welfare needs of children affected by HIV and AIDS whether they can afford to or not. Families in particular carry the bulk of the costs associated with this support (Foster, 2005). Is this provision adequate? If not, can developing countries’ governments afford to support those families caring for children so that the care provided is at least adequate? And what constitutes adequate?

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Shanta Devarajan.
According to economic theory (Samuelson [1954]), public action is justified on two grounds: (i) if there is a market failure, such as the existence of public goods or externalities; or (ii) for redistributing resources from rich to poor people. From this perspective, the case for public action to help AIDS orphans is mainly based on the redistributive rationale. The situation of these orphans is tragic. In addition to losing their parents, AIDS orphans may have contracted the disease themselves. The stigma associated with HIV/AIDS often leaves them excluded from family and social networks. To the extent that governments are committed to helping the most vulnerable members of society, surely AIDS orphans deserve significant public spending. Inasmuch as some of these orphans may resort to crime, prostitution and drugs, with possible spillover effects on the rest of society, there is a "public-good" aspect to assisting AIDS orphans, but this is often a secondary consideration.

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Valerie Leach.
Of course, the short answer to this question is yes it can. The real questions concern the extent of support which can and will be provided, including that from the Government budget, and whether "children affected by HIV/AIDS" warrant special support beyond that which would be available for children who are most vulnerable for whatever reason. Moreover, support specifically targeted at children affected by AIDS runs the risk of being stigmatising and discriminatory, even if it were practically feasible.

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Malcolm McPherson.
In this debate, I am the Grinch. I argue that developing countries (especially those with high–prevalence generalized AIDS epidemics) cannot support the welfare needs of children affected by AIDS. Two reasons stand out. First, developing countries with generalized AIDS epidemics that attempt to accommodate the welfare needs of children affected by AIDS risk undercutting their current and future growth potential. That will further delay their ability to begin assisting on a regular basis all of their citizens who are poor and deprived. Second, the welfare needs of children affected by AIDS are only one of several challenges that these countries face. As such, promoting the welfare needs of children affected by AIDS is no more compelling — economically or financially — than supporting children and adults who are hungry, illiterate, in ill-health, displaced, or otherwise destitute.

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