Children, youths priority in anti-AIDS program

By Mark Connolly

CHIANG MAI, Thailand (JP): Instead of examining sexual health and education for the prevention of AIDS, I thought our minds could explore some broader frameworks that may enable our societies to improve the health and wealth-being of children and youth, which in turn could have a dramatic effect on the AIDS pandemic. For we should all recognize the fact that healthy youth are the key to a nation's health and prosperity. Rich in ideas, energy and creativity, young people are a most powerful resource in AIDS prevention, health promotion and the protection of human rights.

If the health needs of young people are not met and their rights not respected, sexually transmitted diseases, unwanted pregnancies and unsafe abortion; alcohol, tobacco, and other substance abuse and injecting drug use (increasingly popular among young people in this region); violence, and of course, HIV/AIDS will continue to flourish in our communities.

In 1993, UNICEF formed five Technical Support Groups covering the following areas: School-based interventions; sexual and reproductive health; children and families affected by AIDS; health communication and the mass media; and youth health and development promotion.

From this region, there was very strong participation in these groups from Thailand, Myanmar and the Philippines.

I will only speak about one of the five clearly inter-related areas: youth health and development promotion. In the area of youth health, at least four key programming elements have been identified.

I remind you that we are looking at a broader range of issues, not solely HIV/AIDS, but keeping in mind, of course, that such broader frameworks have the potential to enable our societies to eventually get ahead of many epidemics.

In youth health promotion, one essential programming element is a national action plan for youth health -- not just a policy on youth or health, but a concrete plan with responsibilities within several sectors of society. A second key element is school health programs that are aimed at improving both the health and learning capacity of young people in school. A third key component in promoting youth health at all levels are youth friendly health services - accessible facilities that kids don't mind going to because they are treated with respect; services with increase young people's access to and utilization of quality medical and counseling services. A fourth essential component is innovative outreach through youth organizations - focussing on reaching youth out of school and the most vulnerable and exploited -- or as we say in UNICEF-ese, those in "especially difficult circumstances", which includes street children, child laborers, the displaced and refugees, those kids in armed conflict and sexually exploited children and youth.

But there is still something missing in this set of programming elements, for they do not provide the answer to why the interventions work. The "why" is young people themselves. Their genuine involvement in any program, intervention, or activity. Unfortunately, we have historically mistaken youth as merely "needs" rather than "resources".

Young people today have real strength of character and independence, which we must respect. They have strongly defined lines of what they will and will not do, and have a great ability to know who they are and who they want to be. Because of the role we play in shaping the culture in which young people grow and form impressions, we have a special responsibility to young people. We have to take our responsibility seriously.

In many parts of the world, inequality, discrimination and violence still cast a long dark shadow over the lives, livelihoods, minds and bodies of young people. So we need very broad and strong frameworks so that the youth health approach or any of the other approaches we may have can really have an impact on our communities and countries. So in the case of HIV/AIDS, for example, we may need to think about a more modern approach to health and development -- an approach that quite obviously is linked in the United Nations convention on the Rights of the Child, the Convention on the Elimination of all Forms of discrimination against Women, and the Universal Declaration of Human Rights.

For health promotion surely depends on the extent to which the rights of children, youth and adults are protected and respected. These solid, three pillared framework based on rights clearly provide a better framework than the existing doctor-driven biomedical approaches.

These conventions and the declaration provide a bill of rights for all. It is vital that these instruments be implemented in order to bring about real changes in the lives of young people. For it is such "right respected" environments that sexual health and AIDS education -- not to mention many other programs and interventions -- truly have the potential to be highly effective.

When we leave this great gathering in Chiang Mai, some will leave inspired, others depressed. Some motivated, most of us tired. We should all leave with some hope, knowing of course, that hope alone will not get us through this epidemic. But with hope bonded with firm commitments to the protection and respect of rights, we will prevail.

Mark Connolly is an executive of the United Nations Children's Fund (UNICEF), New York Headquarters. The above article is an excerpt of the paper he presented during the Third International Conference on AIDS in Asia and the Pacific from Sept.17 to 21 in Chiang Mai, Thailand.