An African Miracle

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What happens next in Lesotho and the rest of sub-Saharan Africa depends a lot on how broadly these first efforts expand. All the ARVs in the world aren't going to help much if children and their families don't have enough food to build up their strength or clean water to keep from picking up infections. Tough as it has been to focus attention on children with AIDS, it has been harder for clinics to get and use a common antibiotic to prevent pneumonia and other ills in HIV-positive children who don't yet need ARVs. "One of the biggest obstacles in treating children has been having a consistent guardian," says Dr. Martha Sommers, head of clinical services at Embangweni Hospital, a church-run facility in rural Malawi. "Often the guardian is sick or dying, or the children are orphans and getting passed from one guardian to the next."

Some of the challenges go even deeper. "I did not realize how much women lack basic rights in this country," Dr. Julia Kim writes from Swaziland, north of Lesotho. Women traditionally turn over all their income to their husbands, she says, and defer to them on matters of treatment--a practice Kim struggled with when trying to convince one father that immediate care was needed for his daughter whose immune system had collapsed.

Nor are all children who come to the clinics infected at birth. In some parts of sub-Saharan Africa, teenage girls are now eight times as likely to be infected with HIV as their male peers. Study after study has shown that the best way to ensure that young girls who are HIV negative remain that way is to keep them in school, delay sexual intercourse and marriage, help them get good jobs and allow them greater control of their income.

Still, there is reason for hope. The mortality rate for children with AIDS at Baylor's pediatric clinic in Botswana has fallen from nearly 5% in 2003 to 0.3% this year. Other groups are scaling up. More than 1,400 children are receiving antiretroviral therapy in Rwanda--up from 354 in 2004--and more than a third of pregnant women are getting treatment to preserve their lives and reduce the risk of delivering an HIV-positive infant, according to UNICEF. There will always be more to do, but at long last the work has begun.

To see video from the Lesotho clinic and read more about U.S. doctors in the Pediatric AIDS Corps, visit time.com/aidskids

To learn more about the Pediatric AIDS Corps, visit bayloraids.org

Addition: The original version of this story inclueded one web site link. A second link is now included above.