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Save the Children

Missing Mothers: Meeting the needs of children affected by AIDS

This report was written by Christina D’Allesandro, with substantial input from Frances Ellery and Bill Bell.

Save the Children UK

SARPN acknowledges 'Save the Children UK' as the source of this report.
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Executive summary

Millions of children across the world have already lost their mothers to AIDS. Many more are currently caring for their sick mothers, knowing that they will die soon. As their mothers’ health declines – as it inevitably will without treatment – it is the children who end up as the carers, tending to their ailing parents and caring for their siblings.

As well as the emotional cost, the loss of a mother can have a dramatic impact on children’s lives. Children without mothers have less chance of getting enough food to eat, are more likely to miss out on school, and often end up having to care for themselves and the rest of their families. Over time the AIDS pandemic will rob millions more children of their childhoods, as well as robbing them of their mothers.

The AIDS pandemic increasingly has a woman’s face, as more and more women become infected. In all, around 19.2 million women are currently living with HIV – half of all adults living with the virus. Most of these women are already mothers, and between them they are raising millions more children.

In the areas most highly affected by the pandemic, children make up nearly half the population. To date, any recognition of children’s particular needs has focused on what happens after their parents have died. But children living with HIV-positive mothers have significant needs too, and can benefit enormously from any support to the family that can extend their mothers’ lives and ability to care.

Communities are central to efforts to support mothers and children affected by HIV and AIDS. When a mother is sick, it is most often the extended family and the local community that help to support the mother and care for her children. But with the rising numbers of HIV-positive mothers and affected children, communities are struggling to provide support from their own resources and need external help. Millions of dollars have been promised by donors to fight HIV and AIDS, but the failure to meet these commitments, funding bottlenecks, and a lack of focus on supporting children in their families and communities mean the money is not reaching those who are most in need.

Even where their own governments have funds available through social protection and other schemes, such funds rarely reach down to the family or community level. National social welfare schemes providing financial and other benefits rarely have extensive coverage, while existing funding arrangements make it difficult for community-based organisations to access funding. Communities often lack the knowledge and means to claim their share of the resources available.

A number of international commitments exist that indicate a growing awareness of the issue. In 2001, as part of the UN General Assembly Special Session (UNGASS) on HIV and AIDS, the member states of the UN made a commitment to meeting the needs of children affected by the pandemic – many of which arise from their mother’s ill health. A major step forward was taken four years later in the communiqué from the G8 leaders at their 2005 Gleneagles meeting, where they committed to ‘proper support’ for children affected by AIDS.

The best estimate of what it will cost to provide such support to children living in families with HIV and AIDS or orphaned by the pandemic comes from the 2005 UNAIDS Global Task Team (GTT). Their estimate is that $6.4 billion, or 12 per cent of the total resources needed over the next three years to address the AIDS pandemic, should specifically address the needs of vulnerable children.2 Yet to date, only the US, the UK and Ireland have committed funding specifically for this purpose. Even if these three countries live up to their promises, this would amount to just a quarter of what is needed. It is time for donors – in particular the G8 nations, the Global Fund to Fight AIDS, TB and Malaria, the World Bank and the European Commission – to come forward with the resources to support children who are losing their mothers and childhoods to HIV and AIDS.

In 2001, UNGASS made clear commitments for children. In June 2006, the member states of the UN will be meeting again at UNGASS +5 to review progress since 2001. Save the Children urges them to reaffirm the commitments made by the G8, clearly endorse the resource needs outlined by the GTT, and commit to providing the resources needed to provide more and better care for families, supporting mothers to provide continuing care for their children and reducing the numbers of children orphaned by AIDS.

That is why Save the Children is calling for:

  • a focus on better care for mothers and children affected by HIV and AIDS, as well as support for orphaned children
  • at least US $6.4 billion – 12 per cent of promised AIDS funding over the next three years – to be targeted at children and families as recommended by the UNAIDS Global Task Team
  • support for building national social welfare systems that provide direct financial and other benefits to families
  • donors to remove funding bottlenecks and ensure that communities are involved in developing and implementing national AIDS plans, so that funds can reach the most vulnerable children
  • free healthcare and more testing and treatment facilities.
Unless we act now, more women will die and many more children will be denied their mother’s care. The sooner mothers can get support – and the better the quality of that support – the longer they will live and the better able they will be to care for their children.



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