Introduction

The Association d'Insertion d'Aide aux Orphelins (AIAO) helps oprhaned children with school fees and stationery, Burkina Faso. © 2004 Gideon Mendel for International HIV/AIDS Alliance

This section introduces issues affecting orphans and other vulnerable children. More details provided in other sections include:

the terms used when describing issues concerning children and HIV/AIDS
the situation that faces children and young people, their families and communities and the countries in which they live as a result of HIV/AIDS
how people and organisations are responding to these situations

The three waves of the HIV epidemic

HIV/AIDS was first identified in the early 1980s. Since then, it has spread around the world. Millions of people have been infected and millions have died. This global epidemic ('pandemic') has especially affected economically poorer countries, particularly in sub-Saharan Africa. It is now increasingly affecting Asia and the Caribbean. It has been described as having three 'waves'. In the first wave, people are infected with the virus. In the second wave, people become ill. The third wave is made up of the effects of people dying of HIV/AIDS, such as on surviving children and young people. Many countries, particularly in Africa, are already affected by the third wave. Others already have first and second wave epidemics. These countries will inevitably be affected by the third wave in the future - even if no more people are infected with HIV from today.

The impact of the HIV epidemic on children

Many countries are now having to cope with large numbers of children orphaned by HIV/AIDS. These and other countries will have to continue to do so for many years to come. Other children and young people, as well as orphans, lack support and are vulnerable. These include street children, children affected by conflict, disabled children, children affected by HIV/AIDS and girls.

Compared to other children, orphans and other vulnerable children are more likely to:

do badly in school and/or drop out of school
have poor educational and vocational opportunities
begin working at an early age
have poor health and nutrition
lose their rights to land and property
lack love, care and attention
experience stigma and discrimination
experience exploitation and abuse
suffer sexual abuse and exploitation
become HIV-infected
lack emotional support to deal with grief and trauma
experience long-term psychological problems
take drugs and other substances and become involved in crime.

Resiliency of children and young people

Despite all these potential problems for orphans and other vulnerable children, many children and young people show great ability to cope, even with the most extreme circumstances. This is because the majority of children and young people are extremely resilient, particularly when supported by family and community members. Many families and communities are providing considerable levels of support to orphans and other vulnerable children in extremely difficult circumstances.

Supporting family and community responses

Many people and organisations are responding to this issue. There is growing evidence of what works and what does not. Orphanages and other institutions may seem a good idea at first. However, they are rarely an appropriate solution. They are very expensive. They can only ever care for a small percentage of all children in need. They often cater poorly for the psychosocial needs of children and young people and they may undermine what families and communities are doing. The extended family and community are the first line in any response to children orphaned and made vulnerable by HIV/AIDS. Organisations seeking to work in this area should focus on initiatives that support family and community efforts.

The importance of this is summed up in five key strategies for work with orphans and other vulnerable children in the global strategic framework that was introduced in 2004. They are:

Strengthen the capacity of families to protect and care for orphans and vulnerable children by prolonging the lives of parents and providing economic, psychosocial and other support.
Mobilize and support community-based responses.
Ensure access for orphans and vulnerable children to essential services, including education, health care, birth registration and others.
Ensure that governments protect the most vulnerable children through improved policy and legislation and by channelling resources to families and communities.
Raise awareness at all levels through advocacy and social mobilisation to create a supportive environment for children and families affected by HIV/AIDS.

Resources

Building Blocks: Asia: Overview (Eng)

This is the first in a series of seven 'Building Blocks: Asia' publications. It provides an overview of issues for communities working with orphans and vulnerable children in Asia.
International HIV/AIDS Alliance, 2006, PDF, 18 pages, 331 kb

Family and community interventions for children affected by AIDS (Eng)

This document explores the impact of HIV and AIDS on children and provides OVC programming principles. It also contains a large annotated bibliography.
Human Sciences Research Council (HRSC), Linda Richter, Julie Manegold, Riashnee Pather, 2004, PDF, 182 pages, 671 kb

The Promise of a Future: Strengthening Family and Community Care for Orphans and Vulnerable Children in Sub-Saharan Africa (Eng)

This publication highlights the programs and strategies that help ensure that children remain in family care within their communities by reducing discrimination, ensuring access to education, creating income, and providing direct support.
Firelight Foundation, American Jewish World Service, Bernard van Leer Foundation, Pan African Children’s Fund, Kerry Olson, Ruth Messinger, Laura Sutherland & Jennifer Astone, 2005, PDF, 12 pages, 2300 kb

Children on the Brink: Strategies to Support Children Isolated by HIV/AIDS (Eng)

This major and key publication about work with children affected by HIV/AIDS contains statistics on children orphaned by HIV/AIDS from 88 countries, analysis of the trends found in those statistics, and strategies and principles for helping the children.
Hunter, S. and Williamson, J., UNAIDS, UNICEF and USAID, 2004, PDF, 46 pages, 6.3 mb.

Children on the Brink: Strategies to Support Children Isolated by HIV/AIDS (Fre)

Children on the Brink: Strategies to Support Children Isolated by HIV/AIDS (Spa)

A Framework for the Protection, Care and Support of Orphans and Vulnerable Children Living in a World with HIV/AIDS (Eng)

This framework is based on lessons learned over many years. It considers families and communities as the foundation of an effective, scaled-up response.
UNICEF, 2004, PDF, 23 pages, 397 kb.

Africa's Orphaned Generations (Eng)

This report by UNICEF (2003) illustrates life circumstances of orphans and other vulnerable children (OVC) in sub-Saharan Africa.
UNICEF, 2003, PDF, 52 pages, 762592 kb.

Building Blocks: Africa-wide Briefing Notes: Overview (Eng)

This is the first in a series of six 'Building Blocks' publications. It seeks to provide an overview of issues for communities working with orphans and vulnerable children in Africa.
International HIV/AIDS Alliance, 2003, PDF, 20 pages, 326 kb.

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Understanding the Needs of Orphans and other Children Affected by HIV and AIDS in Africa: The State of the Science (Eng)

This review was undertaken to summarize the findings that represent the most up-to-date understanding of issues affecting orphans and other vulnerable children.
Birdthistle, I., AED/USAID, 2004, PDF, 42 pages, 2637 kb.

Orphans and Other Children Affected by HIV/AIDS (Eng)

This UNICEF fact sheet presents the basic facts about the effects of HIV/AIDS on children and then proposes strategies and principles to be followed in responding to these.
UNICEF, 2002, PDF, 2 pages, 499 kb.

Best Practices for Care of AIDS Orphans (Eng)

This brief paper gives a Canadian perspective on a wide range of issues relating to children orphaned by AIDS.
ICAD, 2002, PDF, 4 pages, 103 kb.

Meilleures pratiques dans les soins aux orphelins du sida (Fr)

Ce bref document offre une perspective canadienne sur un ensemble de sujets relatifs aux enfants orphelins du SIDA
Coalition Interagence sida et developpement, 2003, PDF, 108kb, 6 pages

Children and Young People in a World of AIDS (Eng)

This is a general UNAIDS document which describes the effects of HIV/AIDS on children and young people in three main areas.
UNAIDS, 2001, PDF, 16 pages, 926 kb.

Les Enfants et les Jeunes dans un Monde Frappé par le SIDA (Fr)

This is a general UNAIDS document which describes the effects of HIV/AIDS on children and young people in three main areas.
UNAIDS, 2001, PDF, 16 pages, 974 kb.

Los Niños y los Jovenes en un Mundo con SIDA (Sp)

This is a general UNAIDS document which describes the effects of HIV/AIDS on children and young people in three main areas.
UNAIDS, 2001, PDF, 16 pages, 979 kb.

Children and Young People in a World of AIDS (Rus)

This is a general UNAIDS document which describes the effects of HIV/AIDS on children and young people in three main areas.
UNAIDS, 2001, PDF, 16 pages, 926 kb.

Selected reference material concerning children and families affected by HIV/AIDS (Eng)

An extensive list of useful resource materials relating to children and families affected by HIV and AIDS.
Williamson, J., Displaced Children and Orphans Fund, USAID, August 2005, PDF, 230KB, 24 pages

No Excuses: Facing up to Sub-Saharan Africa's AIDS Orphan Crisis (Eng)

This is a hard-hitting and empassioned plea for developed countries to increase the amount of money they make available for development aid.
Lynas, M., Christian Aid, 2001, PDF, 28 pages, 1188 kb.

A Review of Current Literature of the Impact of HIV/AIDS on Children in Sub-Saharan Africa (Eng)

This excellently-referenced article was published in AIDS 2000 Year in Review and provides a clear and concise summary of many of the issues relating to children and HIV/AIDS in Africa.
Foster, G. and Williamson, J., FACT/DCOF, 2000, PDF, 21 pages, 65 kb.

Orphan Alert: International Perspectives on Children Left Behind by HIV/AIDS (Eng)

This report was prepared for the International AIDS Conference held in Durban, South Africa in July 2000. It aims to raise the profile of affected children on the global agenda, and to foster effective action for them.
Lorey, M. (ed.), Association Francois-Xavier Bagnoud, 2000, PDF, 28 pages, 145 kb.

Finding a Way Forward: Principles and Strategies for Intervention (Eng)

This is a draft of the third chapter of a book entitled Finding a Way Forward: Principles and Strategies for Intervention. It starts by revieiwing the impacts of HIV/AIDS on children and families and arguing for communities and families to be seen as the first line response to the epidemic.
Williamson, J., 1999, PDF, 32 pages, 321219 kb.

Building Community-Based Partnerships to Support Orphans and Vulnerable Children (Eng)

This paper was published by FHI in 'Impact on HIV/AIDS' (Vol 2.1) and gives an overview of many issues relating to orphans and vulnerable children as a way of introducing work being planned, for example the SCOPE project in Zambia.
FHI, 2000, PDF, 14 pages, 459 kb.

Orphans and Other Vulnerable Children: What Role for Social Protection? (Eng)

This report on a workshop held in Washington in 2001 starts by stating that the effects of HIV/AIDS on children globally represents an unprecedented crisis and argues for it to be approached through a social protection framework.
Levine, A., World Bank, 2001, PDF, 54 pages, 196 kb.

Workshop Report: Eastern and Southern Africa Regional Workshop on Orphans and Vulnerable Children (Eng)

This is a report of a workshop held in Zambia in 2000 and constitutes a wide-ranging report on the situation affecting orphans and vulnerable children in Southern and East Africa.
Williamson, J., UNICEF/USAID, 2000, PDF, 14 pages, 36 kb.

First National Conference on Orphans and Other Vulnerable Children - Namibia (Eng)

This is a report of a conference held in Namibia in 2001 to discuss issues relating to orphans and other vulnerable children. It looked at the situation in Namibia and considered the results of a study into the issues and projections for the future.
Namibian Directorate of Developmental Social Welfare Services, Ministry of Health and Social Services, 2001, PDF, 25 pages, 214 kb.

Second National Conference on Orphans and Other Vulnerable Children: Facing Challenges, Ensuring Futures - Namibia (Eng)

This document is the report of a conference held in Namibia as a follow-up to one held the previous year.
Namibian Directorate of Developmental Social Welfare Services, Ministry of Health and Social Services, 2002, 94 pages.

Kenya: Orphans and Other Children Made Vulnerable by HIV/AIDS Meeting - Kenya (Eng)

This document is a report of a workshop held in Kenya with the purpose of producing national programme guidelines on working with orphans and vulnerable children.
Kenya National AIDS Control Council Taskforce on Orphans and other Children made Vulnerable by HIV/AIDS, 2001, PDF, 55 pages, 1118 kb.

AIDS Orphans Whitepaper: Role of the General Public (Eng)

This 'whitepaper' consists of a collection of various papers on issues relating to orphans and vulnerable children.
Jarchow, S., 86 pages.

CABA Listserv

This listserv is specifically dedicated to issues concerning children affected by HIV/AIDS.
The Synergy Project.

OVC Taskforce Listserv

This listserv focuses on exchange of information relating to orphans and vulnerable children

UNICEF - HIV/AIDS Website

This website provides a range of information relating to children, young people and HIV/AIDS.
UNICEF.

2002 East and Southern Africa Regional Workshop on Children Affected by HIV/AIDS: Implementing the UNGASS Goals for Orphans and Other Children Made Vulnerable by HIV/AIDS; 25-29 November 2002; Windhoek, Namibia (Eng)

This is the report of a workshop which brought together stakeholders in East and Southern Africa to reinforce awareness of the impact of HIV/AIDS on children and their caregivers and to build commitment to action particularly at the government level.
Loudon, M., UNICEF, USAID, SIDA, NORAD, International Save the Children Alliance, UNAIDS, FHI, Government of Namibia, 2002, PDF, 46 pages, 802 kb.

FHI Focus on Care for Orphans, Children Affected by HIV/AIDS and Other Vulnerable Children (Eng)

This document summarises lessons learned from countries dealing with issues of child development, child survival, children of war and HIV/AIDS in order to produce up-to-date, high quality information for the care and support of orphans and other vulnerable children.
FHI, 2003, PDF, 2 pages, 223 kb.

Reader on Children and HIV/AIDS

This reader lists selected resources relating to children and HIV/AIDS. This includes basic texts that provide an overview on how HIV/AIDS affects children; key legal instruments for HIV/AIDS; best practice documents by thematic areas; and key resources for child rights and HIV/AIDS.
Child Rights Information Network, 2004, PDF, 125KB, 6 pages