In June 2011, the Fifth Global Partners Forum on Children Affected by HIV and AIDS, co-hosted by UNICEF, PEPFAR and UNAIDS, took place in New York. It brought together 115 practitioners, policy-makers, academics and donors to present and discuss evidence-based approaches for responding to the most vulnerable children affected by HIV and AIDS. A number of key challenges and actions were identified for taking the evidence presented to impact, actions which must be taken into account in the current revision of South Africa’s NSP 2012-2016.

Key challenges that were identified include:

• Maintaining care and support on the HIV agenda. Many speakers and participants noted that there is a huge amount of effort put into addressing prevention and treatment, but that care, protection and support of children affected by HIV and AIDS is still lagging a long way behind global needs. Only 11% of households with AIDS affected children get outside support. Programmes at community level remain small-scale, fragmented and often unintegrated in a broader national strategy; they are often not linked to broader health and education outcomes. A key challenge is to ensure that more children are reached through sustainable and nationally owned responses.
• More attention needs to be paid to measuring the impact of programmes in relation to their stated objectives. National M&E systems must be able to track how particular interventions contribute to broader national goals such as health, education, psychosocial and poverty outcomes.
• Strengthening government and civil society partnerships remains a challenge.
• More attention needs to be focussed on the equity and vulnerability intersection. Children that are most at risk are often not able to be reached though mainstreamed programmes; appropriate targeting, based on an understanding of the social, economic and epidemic context in which children live, must guide programme development.

In moving forward:

• There must be a shift in defining and measuring child vulnerability in such as way as to recognise and respond to HIV and AIDS as one of many interlinked stresses faced by children.
• Social welfare systems must be strengthened, in terms of knowledge, human capacity, technical, financial and structural resources, to enable the fulfilment of integral HIV and AIDS mandates.
• Families must be strengthened financially and psychosocially to fulfil their care and protective potential.
• Community systems are central to meeting the need for care and support, prevention and even treatment, but they need to be strengthened and scaled up to be effective and sustainable.
• The prevention and treatment role that can potentially be played by community caregivers is vast but untapped. There is a need to map and unlock this potential.
• The relationship between donors and CBOs needs to be more dynamic, transparent and accountable to community-level needs and respectful and promotive of indigenous responses to children affected by HIV and AIDS.

WEB LINKS FOR THIS ARTICLE

Click here to view the GPF’s Review of key outcomes