 | David Alnwick and Olive Shisana listen to the discussion at the HSRC Satellite Session |
This session explored key issues, efforts and challenges in programme and policy responses to children and HIV and AIDS, reinforcing the view that the focus should shift from orphans to vulnerable children and families. Data collection essential Countries are unlikely to prioritise HIV prevention, care and treatment for children as long as epidemiological data on children with HIV are inadequate, which is the case in most sub-Saharan African countries, said Dr Olive Shisana, CEO of the HSRC. At this stage, only Botswana, South Africa and Swaziland include children in their national HIV population-based surveys. Collection of data on a national scale to determine the size of the problem would be a first step to put children high up on country's national HIV and AIDS agendas, she said. HIV programmes fail the children There are several areas where HIV programmes fail children. These include programmes to prevent mother-to-child transmission of the virus where children are seldom the focus of prevention, treatment and care programmes; even programmes that aim at preventing vertical transmission often end once the mother is discharged from hospital. Another area is voluntary counselling and testing (VTC) for HIV, which is often reserved for men, women and young people, but seldom for children under 10 years old. As the World Health Organisation points out, providing VCT for children presents a problem for policy makers, programme managers and health care providers. When is comes to AIDS treatment and care programmes, health services in most countries focus on acutely ill children with AIDS, and few seek out children in need of antiretroviral treatment. Action to put children on the HIV agenda Shisana advocated for action to put children's issues high up on the HIV agenda. To achieve this, the following need to be done: Collection of data should take place on a national scale to determine the size of the problem; Risk factors should be identified, and intervention strategies be developed; Advocacy materials should be prepared that pinpoints the problem and the action to be taken; and Legal experts should take up children's issues within a human rights approach.
Moving beyond orphans to all vulnerable children Mr David Alnwick, head of the eastern and southern African regional office of the UN Children's Fund (UNICEF) in Nairobi, said the emerging consensus on children is to move beyond targeting orphans for special assistance. 
‘The rates of malnutrition in several countries show that the ratio between orphans and non-orphans is much the same. This is also visible in figures on school attendance, where in many counties it is poverty that keeps children from school, not whether they are orphans or not', he said. The best approach to assist children affected by HIV is to keep them in families and to provide support to poor families who care for additional children, Alnwick said, reaffirming the concept of: ‘A basic cash transfer approach for poor families can be the entry point for building a comprehensive social welfare system.'
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