Rays of Hope for Africa's AIDS Children

Natasha is seen at Bowy House, a home for orphans and sick children, in Paarl, near Cape Town, South Africa, Thursday, June 14, 2007. Natasha is testimony to the success of anti-retroviral medicines in transforming AIDS from a certain death sentence for infants and young children to a manageable disease, providing a glimmer of hope on a continent of gloom. (AP Photo/Obed Zilwa) (Obed Zilwa - AP)

Khayelitsha, where one in four pregnant women is infected, is now home to one of South Africa's busiest anti-AIDS programs, with about 500 children on medication. Wednesdays are dedicated pediatric days and the no-frills clinic set up by MSF reverberates with children's shouts.

Children have remarkably few side-effects, partly because their systems cope better, says Goemaere. But there are other problems; older children battle with rejection by family and friends and often lapse into depression, he says.

The very young can't swallow tablets and have to take multiple doses of syrup, according to a body weight formula that can baffle caregivers _ often illiterate grandmothers. The medicine needs to be refrigerated, difficult in poor areas with no electricity. And cash-strapped caregivers often can't afford the cost of driving kids to clinics.

But there is progress. Prices of ARV drugs for children have come down dramatically over the past 12-18 months. The Clinton Foundation HIV/AIDS Initiative negotiated a reduction in the cost of pediatric drugs _ often taken in combination _ to $60 per year. Pharmaceutical companies previously accused of being greedy are now lining up to fund children's projects in a complex network of public-private partnerships.

The local government provides drugs free of charge to Bowy House, where Natasha has spent most of her life and has come to regard its care-givers and children as her family. Staff there recently drove her on a seven-hour journey over mountains and dirt roads to spend time with her mother, who is dying of AIDS. Natasha has an extended family in her dusty village, but her father is unable to care for her. There is no electricity and no schools.

The girl's favorite activity is to "go tata" _ out for a drive. She adores weekends at the beach, being pushed in a stroller and feeding the ducks. In summer she and her friends chase through the garden sprinklers, despite the risk of catching cold.

"In general we forget that they are ill children. They are naughty and full of mischief but when we see how quickly they can have a setback it reminds us that they aren't normal," says Lombaard.

Natasha's day begins with breakfast and then her first drink of medication at 8 a.m. _ she'll have another at 8 p.m. She doesn't complain about the foul taste because she knows it makes her feel better.

There are morning songs and dance. Natasha, who wears a hearing aid, is partial to "If You're Happy and You Know It, Clap Your Hands."

At lunch, she opens her mouth full of cottage pie and laughs hilariously.

Children at Bowy House are assigned a color to give them "ownership" of something _ Natasha has an orange teddy bear in her cot.

She knows how to defend herself against Luvo, a boisterous 3-year-old boy who also looked like a famine victim when he arrived at Bowy House and now revels in annoying the girls. And she thrashes in fury when Lombaard, her surrogate mother, has no time to pick her up.