“There can be no keener revelation of a society’s soul than the way in which it treats its children.” — Nelson Mandela, former president of South Africa
The impact of HIV and AIDS on children is devastating. To date, an estimated 16 million children have lost one or both parents due to AIDS, 90 percent of whom live in sub-Saharan Africa. And despite dramatic advances in treatment this number is not yet declining . In addition, an estimated 3.4 million children under the age of 15 are living with HIV, and millions more children are made vulnerable due to chronically ill parents or the social and economic effects of living in communities with high HIV prevalence.
These numbers clearly demonstrate how vulnerable children are to the social, emotional, economic, and environmental effects that HIV and AIDS has on families, communities, and countries.
This is why the President’s Emergency Plan for AIDS Relief (PEPFAR) has set aside 10 percent of its funding to address the diverse, complex, and often critical needs of orphans and vulnerable children (OVC). Thus far, nearly five million children worldwide have benefited from PEPFAR’s efforts.
Experience shows us that children can quickly move from being affected by HIV to becoming infected with HIV, particularly if they lack the necessary services and support to address their complex needs. In addition, even when children are not living with HIV, social and economic conditions can impede their ability to lead healthy, productive lives, including as they grow older and potentially become parents to children of their own. Instead of creating an AIDS-free generation, AIDS just skips a generation.
PEPFAR’s efforts have led to dramatic changes in the lives of children, including almost two million orphans averted since the beginning of PEPFAR, through treatment of parents and caregivers living with HIV. We also know that when children lose out on schooling or become victims of abuse and discrimination as a result of HIV entering their lives, these injustices must be addressed. To help remedy this, over the past decade, PEPFAR has worked hand-in-hand with partner countries to provide the physical, emotional, and social support that strengthens families and communities and mitigates negative outcomes for children, including through robust efforts to prevent mother-to-child transmission of HIV and expand access to pediatric HIV treatment.
PEPFAR is firmly committed to sustaining these efforts. To that end, in July 2012, PEPFAR issued new guidance for OVC programming, and on World AIDS Day last year, we released a blueprint that outlines a global path toward achieving an AIDS-free generation. Both documents highlight how family strengthening can better equip parents and caregivers to provide for their children’s needs — emphasizing that child welfare systems strengthening at national and community levels is essential to building country ownership and effectively addressing child vulnerability. The interventions outlined in these documents also support the coordinated objectives in the recently released U.S. Government Action Plan for Children in Adversity, a government-wide plan for vulnerable children, while maintaining PEPFAR’s important mandate to serve children in the epidemic and their unique needs.
The needs of children and families in the epidemic are complex, and include health services, economic security, legal rights, education, child protection, and emotional support. When child welfare systems are strong, children and families are more likely to have their essential needs met. When these systems are lacking, children can face a far different future.
Through its implementing partners, PEPFAR works closely with national ministries and NGOs to expand the scope, scale, and capacity of the social service workforce in partner countries. With PEPFAR support, 17 countries in sub-Saharan Africa have formulated national plans of action for vulnerable children. In Uganda, for example, PEPFAR support has led to the training and accreditation of 1,100 Community Development Officers and probation officers in child protection, who, in turn, provide key services to 66,000 children. In South Africa, with PEPFAR support, the Department of Social Welfare will hire 10,000 new child and youth care workers by 2017. These workers play a vital role in strengthening families to protect children from exploitation and abuse, ensuring children remain in school, and referring children for pediatric testing and treatment — 36,000 of them in 2012 alone.
OVC programs are vital to achieving an AIDS-free generation and preventing child deaths and lost opportunities. They are truly a smart investment in our future. And what could be more important or worthwhile than that?