October 14, 2014 OPINION/NEWS




Anant Mishra

Around the world, hundreds of thousands of lives, societies, and economies have been devastated by the HIV/AIDS pandemic. When disease strikes, children are one of the most vulnerable.

Not only are they at risk of getting sick, but they also suffer if their parents are infected. As a result, increasingly, in Africa particularly, children are becoming the head of the household. Robbed of their childhood, they are forced to take on responsibilities that require a level of maturity that adults, not children, are expected to have. Children in this position often cannot go to school because they are providing for the surviving family members, and often live in dangerous areas without protection. Instead they take on the role of primary care provider for sick parents and younger siblings.

In 2005 it was estimated that 38.6 million people were living with the human immunodeficiency virus (HIV), which then develops into acquired immune deficiency syndrome (AIDS). In many areas the number of new infections continues to grow. Approximately 64 percent of the world’s population that has AIDS lives in sub-Saharan Africa. More women than men are infected. Despite antiretroviral drugs—drugs that target the HIV virus and slow the progression of HIV into AIDS—AIDS remains a fatal disease. As a result, it is estimated that 13.4 million children have been orphaned by HIV/AIDS and millions more live in households where at least one parent has the disease. These children are the orphans and vulnerable children (OVC), “children whose care is compromised as a result of the illness or death of an adult who contributed to the care and/or financial support of the child,” of the HIV/AIDS pandemic.

Traditionally, the extended family would take the orphaned children, but the AIDS epidemic has weakening the extended family support system. As a result, some children have no one to look to for assistance, particularly in rural or underdeveloped areas. In some communities they are ostracized. For others, they are taken as foster children or placed in orphanages which often face overcrowding and understaffing issues.




A devastating disease, HIV is the virus that causes AIDS, a disease that attacks T-cells—white blood cells that are necessary to fight infection. AIDS is the final stage of HIV. HIV is not transmitted through everyday contact such as shaking hands or hugging, but through blood transfusion, sharing of needles, mother-to-child transmission when the mother is pregnant or breastfeeding, or through sexual intercourse. Often, during the early stages of the disease, there are no symptoms. But as the disease progresses, the victim’s weakened immune system cannot fight off opportunistic infections that healthy people’s immune systems can easily overcome. For example, the common cold, shingles, and bronchitis aren’t lethal to a healthy person, but can be deadly for someone who has developed AIDS. However, because it can take up to a decade for someone who is HIV-positive to develop AIDS, people can pass on the HIV virus to others without knowing it.

Currently, there is no cure for HIV/AIDS. However, antiretroviral drugs can be used to slow the progress of the disease. Typically antiretroviral drugs are expensive, in limited supply, and need to be monitored closely when given to a patient. They are offered as “cocktails,” meaning a patient would usually need to take more than one pill a day, which is impractical for those who have no access to health facilities with HIV/AIDS expertise in underdeveloped areas. Additionally, children often cannot find work when they are sick, or cannot earn enough to support themselves and their families and pay for drug treatment. In the developed world, drug companies that hold the patents to HIV/AIDS drugs are often reluctant to sell the drugs at reduced prices to country governments who can’t afford the full- price drugs, which places access to these lifesaving drugs out of even further reach of OVC.


The Protection of Children’s Rights –

In 1989, the Convention on the Rights of the Child (CRC) was adopted into international law. In 54 articles, this document clearly establishes the basic rights of children everywhere. Children, defined as being less than eighteen years old unless the country’s laws recognize the age of majority to be earlier, are guaranteed the right to survival, well-being and development. Generally the family has the primary responsibility of caring for and protecting the child. However, Articles 20 and 22 require that the state take on the responsibility of caring for and protecting the child in situations where the child has been deprived of the family environment. To fulfil its responsibility, the state must consider all the options to ensure that the decisions made are in the best interest of the child. They must also protect all children without discrimination and respect the opinions of the child on all issues affecting them.


History of OVC –

In the last fifteen years, numerous steps have been taken to protect the rights and safety of OVC. The Lusaka Declaration, a declaration addressing many of the issues for children and families as a result of the growing AIDS epidemic, was adopted in 1994. In 1998 the United Nations became directly involved through the UN General Discussion on “Children living in a world with AIDS.” This discussion addressed the view that AIDS is often seen as primarily a medical problem but, in reality, it has a much more significant impact. The Lusaka meeting as well as a later meeting in Pietermaritzburg, South Africa became the framework for meetings in other regions of Africa.


Who is an OVC?

The majority of children orphaned by AIDS live in developing countries with 82 percent living in sub-Saharan Africa. However, as the infection continues to spread, the number of OVC because of AIDS in Asia, Latin America and the Caribbean, and Eastern Europe will increase. Typically, the death of one parent at a young age is not linked with the death of the other parent. In other words, if a child loses a parent to cancer, it is unlikely that his or her other parent will die of cancer at around the same time. As a result, one event usually does not leave a child orphaned. However, because HIV/AIDS is a sexually transmitted disease (STDs), there is a high likelihood that both parents will become infected. With a disease like cancer, one parent may be unable to work, but with HIV/AIDS it is highly probable that both parents will be ill at the same time. Then, many children lose both parents within a relatively short period of time. Children who have lost both parents are referred to as double orphans.


Effects before Parent’s Death –

HIV/AIDS affects families long before the parents die. As the disease progresses, the household income can drop if one or both parents becomes unable to work. The income can drop by more than fifty percent. In agricultural communities, the area of land cultivated by a family can drop by over fifty percent if the head of the household becomes ill. Without this source of income and/or food, the family suffers economically. It can become difficult to meet even the basic needs of daily life on the reduced budget. The cost of treating HIV/AIDS and opportunistic diseases also places a substantial economic burden on families. In Côte d’Ivoire, affected households pay four times as much on health care as unaffected households. Because of these financial burdens, as well as the funeral costs, which can be over one third of the family’s annual income, AIDS can cause extreme poverty even before the parents’ death.

One of the first casualties of the disease for children is schooling. Economic pressures as well as the need to care for sick parents and younger siblings often force children to withdraw from school. In order to support their family, these children then take on adult responsibilities as well as adult jobs, many of which are dangerous. Children are more likely to be working in commercial agriculture, domestic service, or the sex trade. These jobs often result in injury, sickness, and sometimes even death. Because these children are not receiving an education, they are unable to get other, less dangerous jobs which require additional training. Without education, these children also miss out on essential services. Many services created to assist orphaned and vulnerable children are distributed through the local schools. Children who are not in school do not learn about the services they could be receiving. To change this, some organizations are using services, such as providing free food, as a means of encouraging OVC to attend school. Providing food to OVC in school takes some of the burden off of child heads of households so they can attend school instead of having to work.

One of the keys to protecting OVC is protecting and maintaining the health of the parents. Although there is no cure for HIV/AIDS, it is possible to slow the progress of the disease. However, the stigma of having the disease discourages people from getting tested. If the disease is caught early, more can be done to slow its progress. Even if antiretroviral drugs are unavailable, clinics and home care can provide those living with HIV/AIDS with life prolonging treatments for common infections. With treatment, those with HIV/AIDS are better able to lead productive lives, reducing the strain put on their children.


Effects after Parent’s Death –

The death of a parent is devastating. For OVC, it also sets them up for a long trail of painful experiences. Often, after the death of a parent, the child will face economic hardship, withdrawal from school, loss of inheritance, malnutrition, illness, increased abuse, risk of HIV infection and discrimination. In some cases, a child is left without consistent responsive care. This means they are without the love, attention and affection that they need to grow up healthy.

Children’s survival skills suffer when a parent is not present in their life. Many survival skills are passed from generation to generation through parental guidance and support. Without parents to provide this safety net, children and adolescents must improvise because they are forced to take on responsibilities they are not ready to handle. As a result, they are more vulnerable. They are also more likely to become infected with HIV/AIDS, continuing the cycle. Training OVC to handle these responsibilities can greatly reduce the strain put on them. Vocational training and apprenticeships give them skills that allow them avoid working in dangerous occupations as well as enhance their ability to generate income. Often they also need to learn household management skills as well as childcare skills. Through programs that teach survival skills, children and adolescents can also learn skills to help protect them from being infected with HIV and improve their quality of life.

In the past, aid for OVC has focused on material needs. However, after the death of a parent, the children face significant social and psychological needs. These children go without one of the most crucial aspects of childhood: the love and nurturing of parents. This can result in depression and other psychological problems. In turn, this can lead to suicide because the situation may seem hopeless.

Discrimination is a signification problem for AIDS orphans. As a result of their parents’ death, some children become homeless. Living as street children, they face significant discrimination. There is a stigma associated with the term “street children” because they are seen as a source of criminal behaviour. Despite being one of the most physically visible groups of OVC, they are often the most invisible in terms of receiving assistance. Even within their own communities, AIDS orphans are sometimes discriminated against. In some areas, there is a fear that these children are cursed by death so they are avoided.


Risks OVC Face –

Children whose parents are unable to care for them are more vulnerable. They are at greater risk of becoming victims of violence, exploitation, trafficking and other abuses. Parents provide a protective shield of life experience and authority that reduces the likelihood that a child will be victimized. For children living in regions of armed conflict, the risks are further increased. Unaccompanied children are at greater risk of being coerced—forcefully encouraged—into participating in the violence as child soldiers. Girls without parents are at a higher risk of sexual abuse. Often they do not have the skills needed to get a job that provides a sufficient income. As a result, many female OVC will trade their bodies for money, food, or other supplies to meet their basic needs.


The Question of Care –

Many orphaned children are cared for by older siblings or extended family but some enter into institutionalized care. However, orphanages are not the answer. Not only are they more expensive to maintain, they fail to provide children with the necessary attention and love essential to development. Children in these situations have a difficult time reintegrating into society. After studying the effects of orphanages, the governments of Ethiopia, Rwanda, and Uganda are moving away from long term institutionalization. Studies have shown that foster care is a better option. The foster care system has created many different common living arrangements. Each situation has benefits and problems. Female-headed households are more likely to take responsibility of orphans and they generally assume the care of more orphans than male-headed households. The number of grandparent- headed households is increasing. In the past, they have played an important role in caring for orphans but their role has noticeably increased. It has become more common for grandparents to take direct responsibility for the care of their grandchildren. There are also a small percentage of households headed by children under the age of 18. Typically, in these situations, extended family members watch over these households even if they are not providing day to day care. In some cases, adolescents feel more comfortable residing in a group home established and maintained by a NGO than becoming part of a new family. These group homes avoid many of the problems of institutionalized settings while continuing to provide support to these children and adolescents. Frequently, group homes will tend vegetable gardens and raise farm animals to supplement the home’s income. For many children, however, these solutions do not prevent them from being separated from their siblings. Siblings are split up to distribute the burden of care. In Zambia, nearly 60 percent of the orphaned children surveyed have been separated from their siblings.


Past International Actions –

NGOs at Work –

Around the world many different NGOs work together to provide assistance for children affected by the AIDS pandemic. Some, like United Nations Children’s Fund (UNICEF) work specifically with children. Education and food are crucial aspects of the protection of OVC. As a result, many NGOs, such as World Food Programme (WFP), have developed programs that use food as a means of increasing access to education for OVC. Providing food for OVC at schools creates an incentive to stay in school. Otherwise, many of these children would have to drop out of school to work in order to have enough to eat. For those still able to attend school, poor nutrition greatly reduces their ability to learn and depresses a body’s ability to fight off infection.


Convention on the Rights of the Child –

The Convention on the Rights of the Child (CRC) specifically establishes the human rights of children as international law. The document was adopted into international law in 1989 and implemented in 1990. For OVC, this document establishes their rights to protection, care, and identity as citizens of the country in which they were born. Children are any person under the age of eighteen. The United States and Somalia are the only two countries that have not ratified this document.





Anant Mishra

Anant Mishra is a former youth representative for United Nations. Almost 4 years of experience, he has served in number of committees including United Nations Conference for Trade and Development and United Nations General Assembly primarily focusing on international trade, education, finance, economics. food crisis And disputes. He is available on [email protected]


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