Children and HIV and AIDS

Protecting and Supporting Children Affected by HIV and AIDS

© UNICEF/ HQ04-0682/Pirozzi

Five-year-old Alina holds her ballet slippers, at home in the city of Kaliningrad. Alina was abandoned by her father and severely neglected by her mother, a drug addict and alcoholic, who has AIDS

The facts

The loss of one or both parents to AIDS is one of the ways in which children are made vulnerable by the AIDS epidemic. Many more children live in households with sick or dying parents, in poor households that take in orphans, and in communities that have been destabilized by the epidemic. Schools, health care systems, and other social support networks are weakened as teachers, health care workers, and other community members are dying.

According to the 2007 AIDS Epidemic Update, about 11.4 million children in sub-Saharan Africa have lost one or both parents due to HIV or AIDS.

The issues

Children affected by AIDS face grave risks to their education, health and well-being. They may have to forgo schooling; there may be less food or clothing for them in the household; they may suffer from anxiety, depression and abuse. Alarmingly, new evidence finds that orphans and vulnerable children have a higher risk of exposure to HIV than non-affected children.

Poverty remains one of the root causes of vulnerability of children and families affected by AIDS. An increasing number of countries, for example, Zimbabwe, Malawi and Kenya, are therefore experimenting with the provision of conditional or unconditional cash transfers for families affected by AIDS. Experiences are suggesting that these social protection interventions are feasible and affordable. There is increasing evidence that children under the age of three years are at a higher risk of morbidity and mortality if they are orphaned and even if their parent is alive but infected with HIV. Ensuring free regular health checks for these children is important.

The situation of many AIDS-affected children could be significantly improved if governments simply expanded health and education services to the entire population. Thus, one way to address the disparities created by the AIDS epidemic is for governments to reach those who are left out of the system through universal education, the elimination of user fees and other means. Such an approach is consistent with the broad UNGASS goals of addressing factors that make people vulnerable to infection and protecting their health and rights.

UNICEF's role

UNICEF, workingin patnership with the World Food Programme (WFP), the World Health Organization (WHO) and the International Labour Organization (ILO) is the lead organization in providing care and support for people living with HIV, orphans and vulnerable children, and affected households. Within this capacity, a key mechanism for UNICEF’s work is the Inter-Agency Task Team on Children and HIV and AIDS (IATT).  The IATT includes a large number of international agencies and organizations that play a critical role in ensuring the effective implementation of the global agenda for children affected by AIDS as articulated in the Framework for the Protection, Care and Support of Orphans and Vulnerable Children Living in a World with HIV and AIDS.

At the national level, effective national responses provide orphans and vulnerable children with a package of essential services that includes education, health care, social welfare and protection. The need for a decentralized approach is fundamental because much of the response will be made at the community level by non-governmental, local and faith-based organizations. Monitoring and evaluation of service coverage also need to be improved, in order to quantify the extent to which governments, non-governmental organizations and others are responding to the protection and support needs of children and to evaluate the quality of such support.

As of 2007, the issues of children and AIDS have become more clearly integrated into national policy frameworks, including implementation of national plans of action (NPAs) for orphans and vulnerable children in 24 countries, including 21 in sub-Saharan Africa, had completed such plans, and 10 countries in the world, including 9 countries in sub-Saharan Africa, had plans in process.

In Eastern and Southern Africa, UNICEF is supporting pilot programmes of cash transfers to families with orphans and vulnerable children in Kenya, Malawi and Zambia. Cash transfers are regular stipends for ultra-poor and marginalized families. They help families access basic services and maintain a healthy level of nutrition and a sense of dignity. Preliminary results indicate that the grants are associated with children returning to school, greater investment in capital goods to improve income and declining dependency levels among the poor, leading to psychological improvement in households and communities. Evidence also suggests that the nutritional status of children in these households also improved. These positive results have prompted Malawi’s Cabinet to extend the programme to six other districts for 2007.