Protection and support for orphans and families affected by HIV/AIDS

14 million children under the age of 15 have lost one or both parents to AIDS. By 2010, this number is expected to exceed 25 million. Without urgent, collective action, millions more children will face enormous risks in their struggle to stay alive.

The facts

One of the most devastating aspects of the HIV/AIDS epidemic is the growing proportion of children the disease has orphaned. Unlike most diseases, HIV/AIDS generally kills not just one, but both parents. What is more, the stigmatisation and discrimination that people affected with HIV often live with is passed onto their children, making their fight for survival that much more precarious.

When parents or caregivers fall sick and die, a child’s life often falls apart. With HIV and AIDS, the hardship hits well before children are orphaned. First a parent or caregiver becomes ill with HIV or AIDS, and is unable to work. The entire family feels the economic impact – children, especially girls, must often drop out of school to go to work, care for their parents, look after their siblings and put food on the table.

On top of the psychological impact of losing one’s parents, children who lose their parents to AIDS are often stigmatised or ostracised by their communities. These children are often much more at risk of becoming a victim of violence, exploitative child labour, discrimination or other abuses. Surviving children face malnutrition, illness, physical and psychosocial trauma, and impaired cognitive and emotional development. Unaccompanied girls are at especially high risk of sexual abuse. And because of all this, they too are very likely to become HIV-positive.

• In Zambia, a study by the International Labour Organisation in several districts shows the majority of children in prostitution are orphans, as are the majority of street children.
• In Ethiopia, the majority of child domestic workers in the capital city Addis Ababa are orphans.
• In Uganda, focus group discussions revealed that girls orphaned by AIDS were especially vulnerable to sexual abuse in domestic housework because of the stigma attached to their orphaned status.
• Studies from numerous regions have shown that orphaned children have substantially lower levels of education than children who are not orphaned.

Across sub-Saharan Africa, where the HIV/AIDS epidemic is most severe, the extended family traditionally stepped in to take care of children who had lost their caregivers. But this traditional safety net is collapsing under the weight of the HIV/AIDS crisis. More and more orphans are heading up their own households. In Swaziland, as many as one in 10 households are run by orphans. Many more orphans are ending up on the street. In 12 African countries, it is expected that, by 2010, orphans will make up 15 per cent of all children under 15 year old.

The challenge

14 million children under the age of 15 have lost one or both parents to AIDS. By 2010, this number is expected to exceed 25 million. With global infection rates still rising, HIV/AIDS will continue to cause unprecedented suffering among children for at least the next two decades if not longer. It takes roughly 10 years between HIV infection and death from AIDS, so today’s prevalence levels will largely determine the number of orphans over the next decade. Because of the lag time between infection and death, the numbers of orphans will continue to increase even in countries where HIV infection rates are declining.

At the June 2001 United Nations General Assembly Special Session on HIV/AIDS, member countries vowed to develop national policies and strategies that build and strengthen the ability of governments, communities and families to support orphans and children affected by HIV/AIDS by 2003, and to implement those policies by 2005. Achieving that goal will mean providing adequate nutrition, access to education, protection from exploitation and discrimination and addressing a host of other societal ills.

UNICEF’s role

Building effective partnerships

UNICEF is working with governments to help them create national policies, laws and action plans to meet the goals they have committed to. UNICEF is collaborating with non-governmental organizations and UN partners to help communities strengthen the traditional safety nets to care for, support and protect children orphaned or made vulnerable by the disease.

In Southeast Asia, for example, UNICEF has teamed up with Buddhist monks across the Mekong region to break the stigma surrounding HIV/AIDS and to improve care for children orphaned by the disease. UNICEF supports a church-based organization in Zambia called Chikankata Health Services, which assists hundreds of children who have lost their parents to AIDS by raising money to pay their school fees and for medical care. Hundreds of similar organizations around the world receive UNICEF support.

Helping parents live longer

An obvious way to prevent children from becoming orphaned is to help their parents live longer. UNICEF is part of an international effort to give people living with HIV/AIDS expanded access to treatment with anti-retroviral drugs, which can slow or halt the immune suppression caused by HIV. If parents can maintain their health, they are better able to care for their children. Although UNICEF does not have the resources to purchase the drugs, it is directly lobbying drug companies to reduce their prices or donate their drugs, and helping governments strengthen their healthcare systems so that the drugs may be administered successfully. UNICEF also promotes and supports strengthening health care systems to provide drugs for the treatment of opportunistic infections (i.e. tuberculosis, pneumonia, thrush, etc…) which often become fatal for people living with AIDS.

Supporting communities

UNICEF believes that whenever possible, children who are orphaned should remain in their communities to be raised by their extended family. Recognizing that family care is far better for children and far less costly than institutionalized care, children who grow up in families also develop better social skills and are psychologically better adjusted than those who grow up in institutions because they receive more affection and attention and develop a better sense of personal identity.

This is why UNICEF is working with NGOs and community groups to help ensure that families have the resources they need to adequately care for orphaned children. This support ranges from providing psychological counselling and helping parents with succession planning, to job training, paying school fees and providing basic health care.

Copyright © United Nations, 2003