A chance not to be missed

[ By Stefan Germann and Kurt Bangert ]

In a recent edition of The Lancet, the medical journal, Richard Horton (2006) asked: “After 25 years of AIDS, why are children still largely ignored?” Indeed, there is ample reason for frustration and disappointment. The international community has been very slow in living up to the promises made at the Special Session of the UN General Assembly (UNGASS) on HIV/AIDS in 2001. Governments seem oblivious to what large numbers of orphans will mean in the long run for the societies and economies concerned. Sadly, this is apparently as true of donor governments as it is of those in the countries worst hit by the pandemic.

Because of HIV/AIDS, many children are already suffering enormously. There is no easy solution to this crisis. Even today, however, most action on the matter is still driven by non-governmental and community-based organisations. One has the impression that governments and international development agencies believe such action will suffice.

While some national policies have indeed been drafted for orphans and vulnerable children, there is still a dire need to move from rhetoric to action. In the words of Steven Lewis, the UN’s Special Envoy on AIDS in Africa, what has been done so far in most sub-Saharan countries remains “limited in scale, fragmented and shamefully short of what is required to halt this preventable tragedy”.

In June 2001, UNGASS adopted a declaration which committed UN members to a range of actions on HIV/AIDS (UN 2001:28). Articles 65, 66 and 67 directly relate to children. Article 65 stresses the importance of designing national policies by 2003 and implementing them by 2005. These policies should “strengthen governmental, family and community capacities to provide a supportive environment for orphans and girls and boys infected and affected”. Among others issues, school enrolment, access to shelter and good nutrition are mentioned as relevant. Moreover, the children concerned are said to deserve protection against violence, exploitation and various forms of discrimination. Article 66, in turn, stresses affected children’s human rights and calls for a “visible policy of de-stigmatisation”, and Article 67 urges donors, international civil society and the private sector to support sub-Saharan Africa in these matters.

Sadly, these goals are still as vital as ever, but far too little has been done to achieve them in time (Foster, 2005). From 2000 to 2004, UNICEF and UNAIDS facilitated a process among key stakeholders to establish the “Framework for the protection, care and support of orphans and vulnerable children living in a world with HIV and AIDS” (2004). The Framework’s aim was to provide operational guidance and support. It is based on the Convention on the Rights of the Child, which includes the following fundamental principles (Byrne, 1998):
fulfil children’s right to survival, well-being and development,
ensure non-discrimination,
take into account the best interest of the child, and
encourage children’s participation in activities aimed at promoting their well-being.

Accordingly, the Framework emphasises five key strategies for dealing with the HIV/AIDS crisis:
strengthen the capacity of families to protect and care for orphans and vulnerable children by prolonging the lives of their parents and providing economic, psycho-social and other support,
mobilise and support community-based responses,
ensure orphans’ and vulnerable children’s access to essential services, including, among others, education and health care,
ensure that governments protect the most vulnerable children through policies, legislation and allocation of resources to families and communities, and
create a supportive environment for the children and families affected through awareness raising and social mobilisation.

On top of that, the Framework also stresses that it is not enough to focus on HIV/AIDS orphans. Rather, the most vulnerable children and communities deserve special attention. For measures and programmes to succeed, moreover, they need to take into account local needs, traditions and preferences. Participatory approaches serve to ensure that this is done. In particular, children and young people should be actively involved in all stages. Moreover, gender discrimination has to be addressed, and all care and support activities should be linked to AIDS prevention efforts. In any case, external support must strengthen, not undermine, local capacities and initiative.
It is depressing to have to reiterate these principles again and again after 25 years of exposure to HIV/AIDS. Equally bothersome, “intergenerational” transmission of the disease is still far too common. Moreover, it is most irritating that, in the global fight against HIV/AIDS, we face a financial gap of $ 8 billion. Pledges and promises must be kept, as the number of people affected is growing fast. So far, however, it does not look like all donors were prepared to actually transfer the money they have pledged.

Time to act

In this respect, we applaud the Irish government. Irish Aid recently increased overall funding for HIV/AIDS projects, with the provision that at least 20 % of that money be used in support of orphans and other children made vulnerable by the pandemic.

Desmond Tutu, the archbishop emeritus of Cape Town and Nobel peace laureate, recently wrote in a German newspaper: “Germany, as a major world power, must show leadership in meeting the promises made by the G8 and by Europe in particular.” Under the leadership of Chancellor Angela Merkel, the German government should
endorse the “Framework for the protection, care and support of orphans and vulnerable children living in a world with HIV and AIDS”,
consistently and coherently make the fight against HIV/AIDS a priority in the policy-making not only of the Development Ministry but also of all other Federal Ministries,
contribute, from this year on, at least an annual $ 700 million to fighting HIV/ AIDS, making sure that at least 12 % be allocated to orphans and vulnerable children (as demanded by the German Network “Aktionsbündnis gegen AIDS”), and
evaluate regularly to what extent Germany is fulfilling the commitments made at UNGASS.

In a similar vein, the European Union should increase its contribution to the Global Fund to at least 50 percent of the amount needed to fight HIV/AIDS worldwide in order to live up to its role as collectively the most important donor by far. The European Commission should negotiate a clear timetable for increases in genuine new aid until 2010, in order to meet the EU target of ODA amounting to 0.51 percent of GDP. Such new aid should primarily be used to fight HIV/AIDS including the universal access to prevention, care, treatment and primary school education of orphans and vulnerable children living in a world with HIV and AIDS.

Finally, the G8, as the most important body of the world’s largest industrial nations, should, under the leadership of Chancellor Merkel
deliver on the promises made during the G8 at Gleneagles and turn pledges into cash,
stop spreading the myth that there was a lack of absorption capacity for new funds;
ensure that all HIV-infected people and AIDS patients have access, by the year 2010, to life-prolonging medications which would not only benefit those directly affected but also their offspring,
commit to raising adequate funds to meet the funding requirements estimated by UNAIDS as being 22.1 billion US Dollar by 2008, and to
ensure that of that amount at least 12 % be allocated for orphans and vulnerable children.

So far, it is women who bear most of the HIV/AIDS-crisis burden. They suffer from infections, they take care of the diseased, they fend for children and relatives. Orphans and vulnerable children more often than not depend on female support. Perhaps it will take the leadership of the only woman to head a G8 government, Chancellor Merkel, to move the G8 from words to action. The year 2007 provides Germany an opportunity to lead by action, and to lead by example. This chance must not be missed.