Orphans and other Vulnerable Children: Scaling up Responses

Moderator: Mr. Perry Mwangala, USAID Zambia

Presenters: Stan Phiri, UNICEF East and Southern Africa Advisor OVC

Peter McDermott, USAID Africa Bureau

Overview

• Situation• Strategies• Principles• Key considerations• Actions

Today, An Estimated 36.1 Million Adults and Children Are Living With HIV/AIDS,

Most in Developing Countries

(end 2000)

Today, An Estimated 36.1 Million Adults and Children Are Living With HIV/AIDS,

Most in Developing Countries

(end 2000)

Sub-Saharan Sub-Saharan AfricaAfrica

25.3 Million25.3 Million

Latin AmericaLatin AmericaCaribbean Caribbean 1.8 Million1.8 Million

AsiaAsia6.4 Million6.4 Million

North AmericaNorth America920,000920,000

Including 2.7 million children

An Estimated 21.8 Million Adult and Child An Estimated 21.8 Million Adult and Child AIDS Deaths Have OccurredAIDS Deaths Have Occurred

Since the Beginning of the EpidemicSince the Beginning of the Epidemic

An Estimated 21.8 Million Adult and Child An Estimated 21.8 Million Adult and Child AIDS Deaths Have OccurredAIDS Deaths Have Occurred

Since the Beginning of the EpidemicSince the Beginning of the Epidemic

WomenWomen 9 Million9 Million

MenMen 8.5 million8.5 million

ChildrenChildren 4.3 million4.3 million

32

28.7

25.5

22.119.3

17.916.5

14.6

10.3

2.6 2.5 2.1

5.3 4.93.4 2.6

0

5

10

15

20

25

30

35

Infection Levels are HighInfection Levels are HighInfection Levels are HighInfection Levels are High

And They Are WorseningAnd They Are Worsening

1 in 3 Adults in Botswana1 in 3 Adults in Botswana

Are Are Infected and Infected and

May Die Within May Die Within the Next 7 to the Next 7 to

10 Years10 Years

1 in 4 Adults in Zimbabwe, Namibia, Swaziland1 in 4 Adults in Zimbabwe, Namibia, Swaziland

and 1 in 5 Adults in South Africa and Zambiaand 1 in 5 Adults in South Africa and Zambia

The large majority of adults and children

in all high prevalence countries are

HIV negative

Children on the Brink estimates that there are now 34.7million orphans

(either or both parents dead) in the 34 study countries

Children on the Brink estimates that there are now 34.7million orphans

(either or both parents dead) in the 34 study countries

88% are in Sub-Saharan Africa

By 2010, there will be 44.2 Million Orphans of AIDS and Other Causes in 34 Countries

By 2010, there will be 44.2 Million Orphans of AIDS and Other Causes in 34 Countries

0

5

10

15

20

25

Mill

ion

s of

Orp

han

s

Non-AIDS

AIDS

2010

Africa

1990

US Census Bureau

200030

35

40

45

In six sub-Saharan African countries, 20% or more of In six sub-Saharan African countries, 20% or more of all children under age 15 are currently orphanedall children under age 15 are currently orphaned

In six sub-Saharan African countries, 20% or more of In six sub-Saharan African countries, 20% or more of all children under age 15 are currently orphanedall children under age 15 are currently orphaned

30.1

27.425.7

23.7

20.319.7

0

5

10

15

20

25

30

35

Rwanda

Zambia

Central AfricanRepublic

Zimbabwe

Malawi

Uganda

By 2010, in eleven Sub-Saharan African countries By 2010, in eleven Sub-Saharan African countries over 20% of all children will be orphansover 20% of all children will be orphans

By 2010, in eleven Sub-Saharan African countries By 2010, in eleven Sub-Saharan African countries over 20% of all children will be orphansover 20% of all children will be orphans

36.8

34.2

32.232.1

30.9 30.8

26.9

22.622.3 21.5

20.1

0

5

10

15

20

25

30

35

40

Botswana

Zimbabwe

Swaziland

Namibia

Central African Republic

South Africa

Mozanbique

Zambia

Rwanda

Malawi

Lesotho

AIDS orphans in South Africa

33

In many Eastern and In many Eastern and Southern African countries,Southern African countries,

even if new infections leveled by the year 2000...even if new infections leveled by the year 2000...

In many Eastern and In many Eastern and Southern African countries,Southern African countries,

even if new infections leveled by the year 2000...even if new infections leveled by the year 2000...

Infection rates will remain high Infection rates will remain high through at least through at least 20102010

Deaths will not level until Deaths will not level until 20202020

The proportion of children orphaned will be The proportion of children orphaned will be unusually high through at least unusually high through at least 20302030

It will also have other,It will also have other, far reaching consequencesfar reaching consequences

on social structure, economicon social structure, economicdevelopment, and human development, and human

productivityproductivity

The pandemic is undermining The pandemic is undermining twotwo

decades of hard won gains decades of hard won gains in child health and survivalin child health and survival

Multi-faceted Vulnerability

• Morbidity and mortality• Psychological distress• Poverty• School drop-out • Malnutrition and food insecurity• Loss of inheritance• Fear, isolation and stigma• Abuse and neglect• Risk of HIV/AIDS

Under Five Mortality 2000 and 2010

2000 2010

50

100

150

Botswana

02000 2010

50

100

150

Cote d’Ivoire

02000 2010

50

100

150

South Africa

0

With AIDS With AIDS With AIDS

Without AIDS

Without AIDS Without AIDS

Rate per 1000 live births

29

1999 - 2000 Change in Grade 1 Enrolment

36

Families Are RespondingFamilies Are RespondingFamilies Are RespondingFamilies Are Responding

Adopting and fostering childrenAdopting and fostering children

Shifting children to equalize Shifting children to equalize extra burdensextra burdens

Changing member roles and Changing member roles and responsibilitiesresponsibilities

Expanding children’s Expanding children’s participationparticipation

Working harder and more Working harder and more productivelyproductively

Communities Are Responding Communities Are Responding

Forming orphan assistance Forming orphan assistance committeescommittees

Targeting assistance to the Targeting assistance to the most needymost needy

Counseling guardians and Counseling guardians and providing material assistanceproviding material assistance

Protecting widows’ and Protecting widows’ and orphans’ land and property orphans’ land and property rightsrights

Raising funds and starting Raising funds and starting income generating projectsincome generating projects

Pooling labor and resourcesPooling labor and resources

United Nations Special Session on HIV/AIDS Declaration of Commitment:

Children orphaned and made vulnerable by HIV/AIDS

By 2003, develop and by 2005 implement national

policies and strategies to: build and strengthen

governmental, family and community capacities to

provide a supportive environment for orphans and

girls and boys infected and affected by HIV/AIDS

including……..

USAID Response> 60 initiatives in 22 countries• Support to community• Psychosocial support• Education assistance• Food security or nutrition

supplementation• Economic strengthening• Health care access; HIV/AIDS prevention

STRATEGIC CONSIDERATIONS

•The scale of orphaning is enormous, and they are only a portion of the children affected by AIDS

•The problem is long term

•Responses must be developed and sustained at scale

•We have to hit a moving target

•The impacts on children are unprecedented

•Collaboration is essential

•Affected families and communities are the first line of response

•Institutional care cannot solve the problem

•This is a humanitarian, human rights, and social stability issue

•Care and prevention activities must be integrated

• Both the big picture and the impacts at the level of the child and household must be addressed

1. Strengthen the capacity of families to cope with their problems1. Strengthen the capacity of families to cope with their problems1. Strengthen the capacity of families to cope with their problems1. Strengthen the capacity of families to cope with their problems

2. 2. Mobilize and strengthen community-based responsesMobilize and strengthen community-based responses2. 2. Mobilize and strengthen community-based responsesMobilize and strengthen community-based responses

3. 3. Strengthen the capacity of childrenStrengthen the capacity of childrenand young people to meet their own and young people to meet their own needsneeds

3. 3. Strengthen the capacity of childrenStrengthen the capacity of childrenand young people to meet their own and young people to meet their own needsneeds

4. 4. Ensure that governments protect the most Ensure that governments protect the most vulnerable children and provide essential servicesvulnerable children and provide essential services

4. 4. Ensure that governments protect the most Ensure that governments protect the most vulnerable children and provide essential servicesvulnerable children and provide essential services

5. 5. Create an enabling environment for affected children and familiesCreate an enabling environment for affected children and families5. 5. Create an enabling environment for affected children and familiesCreate an enabling environment for affected children and families

Strategies for InterventionStrategies for InterventionStrategies for InterventionStrategies for Intervention

Programming Principles• Strengthen the protection and care of orphans

and other vulnerable children within their extended families and communities

• Strengthen the economic coping capacities of families and communities

• Enhance the capacity of families and communities to

respond to the psychosocial needs of orphans, vulnerable children, and their

• Link HIV/AIDS prevention activities,care and support for people living with HIV/AIDS, and efforts to support orphans and other vulnerable

• Focus on the most vulnerable children and communities, not children orphaned

6. Give particular attention to the roles of boys andgirls, men and women and address genderdiscrimination

7. Ensure the full involvement of young people as partof the solution

8. Strengthen the role of schools and ensure access toeducation

9. Reduce stigma and discrimination

10. Accelerate learning and information exchange

11. Strengthen partners and partnerships at all levels andbuild coalitions among key stakeholders

12. Ensure that external support strengthens anddoes not undermine community initiative andmotivation

SOME SPECIFIC STEPS TO BUILD A STRATEGIC RESPONSE

•Organize a collaborative national situation analysis

•Develop a national policy and strategic plan of action

•Develop, strengthen, expand, and replicate interventions that can be sustained at scale

•Systematically mobilize communities and build their capacities

•Target priority areas with and microfinance services

•Increase access to education for the poorest children

•Increase everyone’s access to health services

•Incorporate psychosocial interventions into all activities

•Monitor, evaluate, and do research on key issues

LessonsStrengthen the protection and care of orphans and other vulnerable children

within their extended families and communitiesOrphanages only as a

last resort

The impact of AIDS on children and youth and on their families is so vast that only a unified effort can truly begin to mitigate its impact.