AIDS Alert International

Global Partners Forum advocates for children

18 million AIDS orphans by 2010

One in six global AIDS deaths and one in seven new HIV infections worldwide are among children under age 15, Also, an estimated 15 million children are orphans because of AIDS, and in sub-Saharan Africa, this number is expected to rise to 18 million orphans by 2010.1

The Global Partners Forum met in London, United Kingdom, in February to bring together representatives from 90 international organizations and governments to discuss strategies for improving the lives of children impacted by the AIDS pandemic.

UNICEF, a sponsor of the forum, has pointed out that less than 10 percent of the children who are impacted by the AIDS epidemic have received public support or services. (See chart about children and AIDS.)

"The major challenge is that in Southern Africa, in particular, where the majority of children affected by HIV and AIDS live, these types of services are generally not provided by the government," says Gerrit Beger, HIV/AIDS section, programme division of the United Nations Children’s Fund (UNICEF) of New York, NY.

"However, it is encouraging to see that during the last 2 years an increasing number of countries in sub-Sahara Africa have started conducting assessments, analysis and planning of actions to support children affected by HIV and AIDS," Beger says. "With increasing funds becoming available from national governments, donors, and funds like the Global Fund, it is expected that in the coming few years we will see a significant scaling up of service provision to children affected by HIV/AIDS."

Many non-governmental organizations (NGOs) do not provide comprehensive services to children affected by HIV, Beger notes.

"The major challenge for many NGOs is that they often work in a relatively small geographically area and only reach a small proportion of all children affected by HIV and AIDS in the country," he says.

At the recently held Global Partners Forum on children affected by HIV and AIDS, strategies were discussed for strengthening the capacity of families to protect and care for orphans impacted by the epidemic, Beger says.

"Some of the areas where urgent scaling up is required include universal access to health care, including prevention of mother to child transmission of HIV; access to treatment for HIV-infected mothers and children; universal access to education; strategies to reduce poverty including social welfare and cash transfer, and access to birth registration to enable legal protection and provision of services," Beger explains.

In many sub-Saharan countries there have been increasing numbers of local and international NGOs providing services to people impacted by HIV/AIDs, Beger says.

"NGOs have done a tremendous job in advocating for AIDS, and initiating and piloting of interventions to support children affected by HIV and AIDS," he adds. "However, because of limited resources and scope of work, NGOs are normally not able to scale up their intervention to a large geographical area not to mention a national level."

What’s needed is close collaboration between NGOs, governments, and others to ensure they all work together towards one nationally agreed plan of support for children affected by HIV/AIDS, Beger suggests.

"There should be one coordination mechanism for all implementing partners to maximize the limited resources available and to prevent duplication and waste," he says. "And there should be one monitoring and evaluation system that allows monitoring progress and through which all partners can learn from each other about what strategies work and which can be scaled up."

The HIV resources pie has not provided well for children impacted by HIV/AIDs.

"It is not just the matter of the pie being too small," Beger says. "Part of the problem is that the available pie might not be suitable for children and that the fork needed to feed the pie is not commonly available."

For example, antiretroviral drugs for adults are commonly not suitable for children as they are not in the right dosage and are often in pill form when a syrup version would be more suitable for young children, Beger explains. Some antiretroviral dosages don’t exist as drug companies have too small of a market for these in industrialized countries, he says.

"Where they do exist they are often much more expensive than adult dosages," Beger says. "It is encouraging to see that the pharmaceutical industry is increasingly responding to pleas by UNICEF and other partners to develop dosages suitable for children and reducing the prices."

The other challenge is that when policy makers think about treatment, they normally think about treatment for adults only, so it’s important to advocate to policy makers to include treatment for children when they’re developing treatment policies and guidelines and allocating resources, Beger adds.

The Global Partners Forum lists education as a major area of focus because in the worst-affected countries, HIV/AIDS disrupts the demand for education, resources available for schools, and the supply of teachers.

"The most important thing is to remove financial barriers to education," Beger says. "In many countries parents and guardians pay school fees and many other costs like books, and uniforms."

Taking away the financial barriers will be a key strategy in increasing access for the most vulnerable children, including children who are affected by HIV and AIDS, Beger says.

The impact of the epidemic has such far reach that even teachers who are not themselves infected with HIV often may miss work because they are caring for sick relatives, and their absences impact morale and working conditions, he says.

The poorest households often cannot afford school fees, the cost of uniforms and educational materials, and as the epidemic spreads, children are missing out on the knowledge and confidence they’ll need to protect themselves and achieve productive lives.1

The 2005 World Summit addressed this issue by resolving to urgently implement a number of quick-impact initiatives, including the elimination of user fees for primary education.1

Reference

  1. A call to action; Children, the missing face of AIDS. UNICEF. 2005:1-28.