On December 1, 2003—World AIDS Day—Alicia Keys fans huddled close to their computer screens to watch a live AOL webcast of the soulful singer performing before a packed house at New York City’s Webster Hall. The webcast was no mere awareness raiser. AOL linked viewers to a public-service announcement that Keys taped for the launch of Keep a Child Alive (KCA), a new AIDS charity through which Keys pays for treatment for two HIV positive Kenyan children and two mothers. “We need to get involved because these are real people,” the stylishly coiffed diva says, “and so many of them are children.” Cut to an adorable, grinning African child.

The PSA is emblematic of a growing—and potentially troubling—trend in AIDS giving. KCA lines up sponsors who commit to paying $30 a month or more for at least two years to treat a Kenyan or South African child or parent with HIV. It has only 100 donors so far but in three years hopes to have 50,000 sponsors who’ll pledge $36 million to buy meds for 50,000 Africans. “Sometimes you need an underground movement to shape the world in a whole new way,” Keys says.

Child sponsorship is hardly new to the charity world—KCA was modeled on Save the Children, Feed the Children and the Christian Children’s Fund—but it’s almost entirely new as a strategy for getting treatment to HIVers in the developing world. KCA is the boldest of a handful of recent initiatives attempting to mobilize the battle against global AIDS by directly connecting the average American citizen to children with HIV—a connection best-forged, it seems, by a celebrity. Oprah Winfrey has already proved that by making kids in South Africa—many HIV positive or AIDS orphans—her cause célèbre, she could prompt viewers to part with $7.2 million. The imperiled multibillion-dollar United Nations Global Fund to Fight AIDS, Tuberculosis and Malaria has also caught on, backing child sponsorship and enlisting the efforts of Tom Hanks to give people’s heartstrings a shameless tug. These groups argue that given the West’s criminally slow global AIDS response—25 million Africans have died; 40 million people are infected worldwide; 14 million children have been orphaned—shameless trumps helpless.

When word of KCA reached POZ, we couldn’t help recalling the enduring cultural image of child sponsorship: Sally Struthers’ campaign for Save the Children. Surrounded by emaciated, fly-ridden African tots, the fading star pleaded her way into viewers’ checkbooks. At least KCA has A-list celebs—Rod Stewart, Usher, Avril Lavigne, Cher—to promote its mission, but imagine the bad-taste potential: Cher (never known for social awareness) wading through a sea of AIDS orphans in a feathered headdress singing “Believe.” A stretch? Sure. But so was Sally.

More troubling are the late-’80s investigations that revealed that groups like Save the Children put substantial donor dollars toward marketing and overhead. (The rehabilitated Save the Children has since earned four stars from the watchdog Charity Navigator.) KCA intends to cover its overhead and marketing with grants, corporate sponsorships and corporate donations, so all treatment-sponsor money (except for a 3 percent credit-card processing fee) goes directly to meds. But other, more philosophical criticisms of Save the Children, including sponsors’ tendency to ignore the cause once they’ve sent in their checks, are relevant to KCA, too. Might KCA donors pay for treatment and ignore urgent political battles over funding condoms and inexpensive generics? Further, when it comes to the endless complexities of global AIDS, is paying for a single person’s meds the best use of people’s hard-earned dollars? And what are the implications of prioritizing “innocent” children over the disease’s other frequent targets—gays, IV-drug users, sex workers—who are often stigmatized for having it?

KCA was cofounded by Leigh Blake, a private AIDS fundraiser and music producer whose credits include Red, Hot and Blue and Red, Hot and Dance, two landmark benefit albums that raised millions for AIDS in the early ’90s. Blake is the first to acknowledge her new group’s shamelessness. “The name is all about getting people to care, which has been very hard to do,” says the 49-year-old Brit. “We reel you in and beg you to save a child and then save their parent, too.” Blake argues that KCA has “hijacked” child-sponsorship methods and revamped them: “I have problems with picking a kid on a website”—à la Save the Children—“we are T-cell-count driven. Our eligibility is based on health.” Blake also points out that KCA, in partnership with the DC-based foundation Global AIDS Alliance, plans to follow up with donors to mobilize them to “shame governments into doing more.” She envisions an e-mail-based movement similar to MoveOn.org.

Activist AIDS organizations, not always keen on AIDS charities that favor a personal approach over a political one, quietly support KCA. “Individual action can make important contributions until governments meet their responsibility to address the global AIDS disaster,” says Paul Davis of HealthGap, the premier U.S. global treatment-access group. Jesús Aguais, executive director of AID for AIDS (AFA), a New York City nonprofit that sends unused AIDS meds from the U.S. to hard-hit countries, says, “It’s not the only answer, but this kind of initiative can work.” Without a celebrity lure, AFA has enlisted 40 sponsors for its own recently launched treatment-sponsorship program, which is not child-based. Says one staffer, “We’d love to have Susan Sarandon.”

Hopefully, Blake can stay true to her vision of how a child-sponsorship charity should be run—if she can, there’s reason to believe that KCA’s mix of star power and needy kids could have a substantial impact in Africa. In December 2002, Oprah delivered Christmas presents to 50,000 South African children, many of them AIDS orphans or HIV positive. A year later, her Christmas Kindness project was featured on her show, Oprah, and viewer donations flooded in. Oprah herself pays for care for two girls, both of whom lost mothers to AIDS, and funds a “leadership academy” for girls, proving that the personal can lead to the political. The Christmas Kindness segment, and the related stories on Oprah’s website, break your heart as even the most heinous statistics can’t. No surprise then that her fans’ $7.2 million in contributions exceed that of many countries’ donations to the Global Fund.

Before Bush came along in 2002 with his proposed $15 billion dollar Presidential Emergency Plan for AIDS Relief (PEPFAR), the Global Fund was the premier response to global AIDS. But not only has Bush tied PEPFAR to abstinence-only prevention and flip-flopped on inexpensive generics, he has largely circumvented the Global Fund, which is billions short. (These and other global politics have derailed the World Health Organization’s plan to treat 3 million HIVers worldwide by 2005.) Hollywood (and kids) to the rescue!

In 2002, Silicon Valley entrepreneur and philanthropist Ed Scott—a founder, along with U2 frontman Bono, of the organization Debt, AIDS, Trade, Africa—wrote the Fund a $1 million check specifically to educate U.S. citizens and politicians about its AIDS crusade. Since those objectives don’t fall under the Fund’s mandate, Scott and Fund executive director Richard Feacham agreed that Scott would found an organization called Friends of the Global Fight to market the Fund “directly to Americans,” according to a press release.

In the fall, Motion Picture Association of America lobbyist and showman Jack Valenti will step down to become the president of Friends. Like Blake and Oprah, Hollywood insider Valenti knows what sells. Valenti has produced a 10-minute film called Hope to Fight For, explaining “why Americans should be involved” and narrated by Tom Hanks.

The film shows PWAs in developing nations recovering from AIDS thanks to meds. But the similarities to the old Struthers ads are unmistakable: We see image after image of emaciated men, women and, especially, children—some of them crawling with flies. As one of the film’s talking heads, Valenti pleads the case of “innocent little babies, little innocent children and innocent women” who have HIV. “What tears your heart is the huge number of innocent children infected through no fault of their own,” he said when Friends announced his appointment.

While Valenti, new to the world of AIDS politics, may be given a temporary pass for such comments, Hope to Fight For shows how the too personal can become politically dangerous. By attempting to connect with people about AIDS so viscerally—flies, children, celebrity gravitas—Friends appears to pander to folks who believe that the disease claims both innocent and guilty victims. There’s no telling how that influences Friends’ audiences with regard to gays, IV-drug users or even people of color in the U.S., the country’s most at-risk but underserved community.

Clearly, children and celebrities are becoming the anti-complacency AIDS strategy of the moment. Sometime in 2004, Friends will distribute its film to schools and churches throughout the country, with a motivational booklet. It suggests people donate to just one other organization besides the Global Fund. That honor goes not to established if controversial groups like Doctors Without Borders, which treats 13,000 HIVers in 25 countries, or South Africa’s Treatment Action Campaign, which combats possibly the biggest AIDS catastrophe in Africa. Instead, Friends asks you to support a little-known outfit called Keep a Child Alive. “It’s a compelling way to appeal to people who have an interest in giving,” says Anil Soni, Friends’ executive director. Or, as Blake says, sponsoring a child may be a drop in the ocean, but it’s also, “my drop in the ocean. It’s what I can do to save people now, instead of waiting for the big answer, which is taking too long to come.” And on that count, even POZ cynics wouldn’t disagree.

Additional reporting by David Kirby