Despite the a reinforced focus on HIV/AIDS in development strategies and programmes, global HIV infection rates continue to rise and the number of vulnerable children and orphans continues to grow. Can a broad, collective response involving all stakeholders be implemented to overcome the impact of HIV/AIDS on children? This report, compiled by the United Nations calls for greater coordination and creativity in supporting families and communities as the foundation of an effective, scaled-up response.
Almost three million children are infected with HIV or living with AIDS and more than 15 million children have lost one or both parents to AIDS, the vast majority in sub-Saharan Africa. Families and communities are providing the front-line response to the plight of these children, yet few resources are reaching them and they are struggling under the strain. A turning point can only be achieved through a common agenda.
Under normal circumstances, the death of one parent is not linked to the death of the other. With HIV/AIDS, however, children are losing both parents in a relatively short space of time. As parents become ill and die, children become more vulnerable in a number of ways:
- Children often assume responsibilities as heads of households and suffer economic hardship in the absence of parental income.
- Without parental care, children often lack love, attention and affection and forego the learning of basic skills needed for the future, including matters related to household management, nutrition and health, including HIV/AIDS prevention.
- Many children living with HIV/AIDS, particularly girls, are forced to withdraw from education, with the result that they are denied a valuable support and friendship network alongside the opportunity to build a better future for themselves.
- The illness and death of parents causes extreme psychological distress in children, along with the increased fatalism that is intensified by the accompanying stigma often attached to HIV/AIDS.
- In the absence of parental protection, economic pressure places vulnerable children at increased risk of malnutrition and illness and at greater risk of sexual exploitation and, by extension, HIV infection.
In hard-hit countries, government capacity has been drained as a result of increasing demands and widespread staff infection. The burden of vulnerable children and orphans often falls on families and communities, but fragmented responses are exposing their limitations. The framework reinforces the need for greater coordination among stakeholders in future policy processes:
- Children are not merely recipients or beneficiaries, but also rights-holders and their participation in policy strategies is essential.
- Interventions must aim to enhance the economic resilience of the household and involve families and children in planning activities in order to encourage self-sufficiency.
- National development and poverty reduction strategies should be tailored to ensure that the most vulnerable households are reached.
- Community-based efforts aimed at good child-rearing practices and caregiver support must be expanded and strengthened.
- Access to antiretroviral therapy, healthcare and inexpensive medicines for the treatment of opportunistic infections must be made more widely available to prolong the lives of HIV-infected parents.
- A partnership must be cultivated among governments, local leaders, donors, faith-based and other groups, journalists, professionals, and those affected by the virus in order to ensure active collaboration, efficient resource allocation and the implementation of mutually reinforcing programme strategies.
