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Advancing the response to children affected by HIV and AIDS

June 2, 2011


I am currently in New York to participate in the fifth Global Partners Forum (GPF) on Children affected by HIV and AIDS. Hosted by UNICEF, the GPF serves as a platform for organizations playing part in the global response to HIV and AIDS to discuss
and advance its agenda, particularly with respect to children. The first GPF was held in 2003 and participants include donors and international organizations such as UNAIDS, World Bank, USAID, Global Fund as well as government representatives, policy makers and academic partners. This edition of the GPF is entitled ‘Taking Evidence to Impact’ in a bid to identify lessons
learned to guide future initiatives in tackling the issues faced by children  affected by HIV and AIDS. Social protection is now widely considered as an important element of such initiatives, moving the response beyond being primarily health-focused. My contribution to the meeting follows from a documentation of UNICEF’s Children and Aids Regional Initiative
(CARI) in Eastern and Southern Africa, which led to the formulation of key challenges and opportunities in scaling-up the social protection response to children affected by HIV and AIDS.

Child- and HIV –sensitive social protection is often used as the catch-all term for denoting a wide range of programmes and interventions to respond to particular vulnerabilities faced by children affected by HIV and AIDS. Although the boundaries of child- and HIV-sensitive social protection prove difficult to pin down, with blurry delineations of what is considered within or outside of the remit of social protection, the concept is firm in emphasizing the sensitive nature of the social protection response. That is to
say that programmes and interventions do not need to be exclusively focused on or targeted to children affected by HIV; neither in terms of the groups of children benefiting from such programmes nor in terms of the types of problems being tackled. Although intuitively appealing, focused interventions may work rather counterproductive with a very restrictive response to the complex
realities faced by children and potential creation of stigma and taboo.

A global review of child and HIV-sensitive social protection interventions coupled with fieldwork in five countries (Botswana, Malawi, Mozambique, Swaziland and Tanzania) led to the identification of a number of key messages when scaling-up the social protection response to children affected by HIV and AIDS.

–       Social protection for children affected by HIV needs a systems approach.  Rather than supporting particular aspects of social protection programming, ranging from cash transfers to psycho-social support, a coherent response should acknowledge that social protection does not stand on its own but has linkages to other sectors such as health, education and child protection. Efforts to
extend social protection interventions should explicitly acknowledge such cross-sectoral linkages and actively seek to strengthen and build on those.

–       International organizations and NGOs have a crucial role to play in the provision of social protection by providing bottom-up involvement and holding government accountable for the accessibility and quality of services. At the same time, it is crucial that they do not undermine government social protection schemes through, for example, running parallel programmes.

–       The need for social protection interventions to move beyond addressing economic vulnerability only is now widely recognized. Reality on the ground, however, suggests that the social protection response follows a hierarchy of needs; the extension of social protection to include programmes responding to issues of social inequalities, child protection and stigma appear to be an attainable option for a limited number of countries with ample financial and human resources. Efforts to scale-up social protection require critical thinking about how non-economic needs can also be adequately addressed in resource-constrained contexts.

–       Urbanization, innovation and children being ‘re-orphaned’ present new realities on the horizon that are likely to change
the face of social protection
and its role in the response to children affected by HIV. They give rise to new opportunities but will also pose new challenges; early and widespread recognition of these new realities are crucial for the formulation of an adequate and coherent rather than ad-hoc and piece-meal response.

As a representative of IDS and CSP, I will bring these key lessons, coupled with country examples, to the table during the GPF meeting to spark and inspire debates in a bid to advance thinking about social protection as part of the response to children affected by HIV and AIDS.

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