The numbers are staggering. Every year, more than 10 million children in developing countries die before reaching their fifth birthday. Of these deaths, seven million are caused by one or more of five common and eminently preventable conditions: pneumonia, diarrhea, malaria, measles, and malnutrition. To put it bluntly, every day almost 20,000 children die not so much from disease as from callous complacency, killed by conditions that could be prevented or cured with simple, affordable remedies – vaccinations, bednets, food, clean drinking water and antibiotics.

Since PIH first started working in Haiti in the mid-1980s, we have striven to eliminate this unnecessary suffering and death by providing free comprehensive health care for children and their families and by working to ensure that children have access to the basic rights and needs that are keys to a healthy, productive life.

Zanmi Lasante’s first initiatives in Haiti included not only vaccination and treatment for childhood diseases but programs to feed malnourished children, to provide clean water sources to prevent waterborne disease, and to ensure that children were not denied an education because their families could not afford to pay for school fees, books, supplies, or uniforms. PIH’s networks of community health workers regularly conduct vaccination and education campaigns and monitor children’s growth in the communities where our patients live. In this way, PIH works to reach every child with prevention, lifesaving treatment and hope for the future.

Pediatric HIV: Prevention and treatment are possible

Over the past decade, the HIV/AIDS epidemic has emerged as one of the biggest causes of disease, death, and destitution for children. Worldwide, 2.3 million children are living with HIV, the vast majority of them in poor countries. Ninety percent of these children were infected during childbirth, despite the fact that a simple and highly effective treatment for prevention of mother-to-child transmission (PMTCT) of HIV became available more than a decade ago. In developed countries, the rate of transmission from HIV-positive mothers to their newborn babies promptly dropped from 30 percent to just 2 percent. But the story was very different in the developing world.

If the same treatment had been rapidly made available throughout the world, ninety percent of the millions of child deaths from HIV since 1994 would have been prevented. Instead, most pregnant women in poor countries still do not have access to PMTCT, and an estimated 1,500 children are newly infected with HIV every day. Although antiretroviral treatment can offer children living with HIV the same lifesaving benefits it has for adults, 88 percent of HIV-positive children do not have access to the treatment they need.

The AIDS pandemic has also shattered the lives and hopes of tens of millions of children who are not infected themselves but have watched one or both of their parents fall ill and die. An estimated 12 million AIDS orphans live in sub-Saharan Africa alone; millions more children care for parents or other family members who are sick. As the scale of the epidemic overwhelms community support systems and national resources, an increasing number of AIDS orphans are left with only each other for help, struggling to survive as child-headed households. In some devastated areas in Africa, almost 5 percent of households are headed by orphaned children. The increased vulnerability of these children only deepens the conditions of sickness and poverty that fuel the spread of HIV/AIDS.

Partners In Health and Zanmi Lasante began offering PMTCT and HIV counseling to pregnant mothers in Haiti in 1995, just one year after the success of PMTCT was established in the US. Since 2000, Zanmi Lasante’s HIV Equity Initiative has provided ART free of charge for hundreds of children living with HIV. HIV care for children is fully integrated into other basic health services, also provided at no cost. In 2005, clinicians from Zanmi Lasante traveled to Rwanda to assist the medical team at Rwinkwavu Hospital in implementing the Haitian model for PMTCT and management of pediatric HIV/AIDS.

Supporting children’s right to health
at PIH projects and around the world

The needless suffering of children throughout the developing world has long been a driving force for Partners In Health. As PIH has continued to grow, so too has our commitment to children’s rights.

In Peru, Socios En Salud’s program Salud Infantil (“Child Health”) serves children in the deeply impoverished communities of Carabayllo in northern Lima. SES brings health professionals to community clinics to offer treatment and regular checkups for children who would not otherwise have access to care. Community health workers and volunteers visit patients in their homes, distributing medicine and food to children who are sick or underweight and providing advice and encouragement to their families. Salud Infantil also runs an after-school program for vulnerable children and youth at its community center in Carabayllo. Innovative programs engage at-risk teenage youth, offering counseling in life skills and a chance to serve their communities as youth health promoters. During the summer, youth health promoters and SES staff direct special activities for the children of Carabayllo, including art classes, swimming and music lessons, traditional dance workshops, and sports programs.

In Rwanda, Inshuti Mu Buzima provides inpatient care and surgery, outpatient and extension services, and malnutrition rehabilitation for children free of charge at Rwinkwavu Hospital and other sites, in conjunction with the Rwandan Ministry of Health. In its first year, IMB treated 366 children for malnutrition and started more than 100 children on treatment for HIV at Rwinkwavu Hospital alone. PIH and IMB also subsidized the cost of school uniforms and other supplies for 1,500 children who would otherwise have been unable to attend school and established a children’s soccer league for both boys and girls in the area around Rwinkwavu.

With these and similar programs at other sites, PIH is merely bringing to children in the poor communities where we work the same essential rights and services that have virtually eliminated deaths from common childhood ailments in rich countries.

Universal access to public education, vaccination campaigns, child labor laws, infant nutrition and school feeding programs, and state-sponsored health care for children led to many of the greatest advances in public health in developed countries. These and other rights are enshrined in the Convention on the Rights of the Child, which guarantees every child the right to life, education, health care, an adequate standard of living, and freedom from economic exploitation and other abuse.

Adopted by the United Nations in 1989, the Convention is the most widely ratified treaty in existence, signed by every recognized country except the United States and Somalia. Yet for millions of children in poor countries these rights remain far out of reach. In many cases they have become more unattainable, as donor countries and international financial institutions insist that developing countries privatize public services or charge user fees that the poor simply cannot afford. These demands are made in the name of “cost-effectiveness.” But the failure to implement proven approaches to upholding children’s rights is costing millions of children’s lives and billions of dollars in lost productivity and life-years.

PIH strives to ensure that the rights of the child are realized in the communities where we work and to join others in building a movement to demand that the nations of the world live up to the commitments they made almost two decades ago.