1. 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

2. Overview Situation Strategies Principles Key considerations Actions

3. 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 Africa 25.3 Million Latin America Caribbean 1.8 Million Asia 6.4 Million North America 920,000 Including 2.7 million children

4. An Estimated 21.8 Million Adult and Child AIDS Deaths Have Occurred Since the Beginning of the Epidemic An Estimated 21.8 Million Adult and Child AIDS Deaths Have Occurred Since the Beginning of the Epidemic Women9 Million Men8.5 million Children4.3 million

5. Infection Levels are High And They Are Worsening

6. 1 in 3 Adults in Botswana Are Infected and May Die Within the Next 7 to 10 Years 1 in 4 Adults in Zimbabwe, Namibia, Swaziland and 1 in 5 Adults in South Africa and Zambia

7. The large majority of adults and children in all high prevalence countries are HIV negative

8. 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

9. 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

10. 0 5 10 15 20 25 Millions of Orphans Non-AIDS AIDS 2010 Africa 1990 US Census Bureau 2000 30 35 40 45

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

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

13. AIDS orphans in South Africa 33

14. In many Eastern and Southern African countries, even if new infections leveled by the year 2000... In many Eastern and Southern African countries, even if new infections leveled by the year 2000... Infection rates will remain high through at least 2010 Deaths will not level until 2020 The proportion of children orphaned will be unusually high through at least 2030

15. It will also have other, far reaching consequences far reaching consequences on social structure, economic development, and human productivity The pandemic is undermining two decades of hard won gains decades of hard won gains in child health and survival

16. 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

17. Under Five Mortality 2000 and 2010 20002010 50 100 150 Botswana 0 20002010 50 100 150 Cote d’Ivoire 0 20002010 50 100 150 South Africa 0 With AIDS Without AIDS Rate per 1000 live births 29

18. 1999 - 2000 Change in Grade 1 Enrolment 36

19. Families Are Responding Adopting and fostering children Shifting children to equalize extra burdens Changing member roles and responsibilities Expanding children’s participation Working harder and more productively

20. Communities Are Responding Forming orphan assistance committees Targeting assistance to the most needy Counseling guardians and providing material assistance Protecting widows’ and orphans’ land and property rights Raising funds and starting income generating projects Pooling labor and resources

21. 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……..

22. 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

23. 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

24. 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

25. 1. Strengthen the capacity of families to cope with their problems 2. Mobilize and strengthen community-based responses 3. Strengthen the capacity of children and young people to meet their own needs 3. Strengthen the capacity of children and young people to meet their own needs 4. Ensure that governments protect the most vulnerable children and provide essential services 4. Ensure that governments protect the most vulnerable children and provide essential services 5. Create an enabling environment for affected children and families Strategies for Intervention

26. 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

28. 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

29. 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

30. Monitor, evaluate, and do research on key issues

31. Lessons Strengthen the protection and care of orphans and other vulnerable children within their extended families and communities Orphanages only as a last resort

32. 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.