Themes
1. Orphanhood & vulnerability are
exacerbated by the HIV/AIDS epidemic
and associated bereavement and
destitution: an overall response relates to
controlling the epidemic and mitigating its
socio-economic impact
Themes
2. Preventing orphanhood is part of the
strategy: VCT to reduce births to HIV+
parents, and keeping parents of young
children alive
3. Care and protection of orphaned children
can be improved by specific
interventions: access to food, health
care, and love; breastfeeding; preventing
abuse; ensuring a future
Theme 1: Overall impact
Research:
• Spiral of destitution; how to intervene
• Role of food, safety nets
Challenges:
• Acceptance of new paradigm for scale &
newness of problem
Theme 1: overall impact
US Govt actions
• New parameters on resource allocations: long-
term relief perspective (food & meds)
• Sustainability & dependency less relevant
• Exit strategy is when problem is licked
• Invest in & develop capacities of govts &
institutions to develop & implement needed
policies & programmes
Theme 2: preventing orphanhood
Research:
• Uptake of VCT with or without ARV
• To keep parents alive: effectiveness of
nutrition, ARVs (PMTCT Plus), possible
toxicity of ARVs for breastfed children
• Better knowledge of nutritional status,
including anemia & MN deficiencies
(adults & children)
Theme 2: preventing orphanhood
Challenges:
• Forge consensus on responses
• Decide on use of food aid/monetization
• Safety nets for affected families
• Find new approaches to livelihood
• Find effective approach to community
organizations
Theme 2: preventing orphanhood
Responses:
• Scale up PMTCT+ and HAART for HIV+
parents
• Implement safety nets to provide
resources to affected families
• Implement support to community-based
programmes
Theme 3: care & protection of
orphans
Research:
• Understand the barriers to equitable access to
food & health care
• What are way to enhance quality of
guardianship & care (including incentives for
men)
• Health & nutritional needs of OVC > 5 yrs
• How to prevent abuse & HIV infection of OVC
• Ways to tailor existing efforts (e.g., IMCI,
IMPACT) to meet specific needs of HIV-infected
& affected children
Theme 3: care & protection of OVC
Challenges:
• Infrastructure & human resources (inadequate &
becoming depleted)
• Spiral of destitution (reduces capability to care &
protect)
• Targetting & reaching the most vulnerable via
food distribution, health interventions
• Fostering collective sense of responsibility for
children, & initiatives to prevent abuse
• Substitutes for mothers’ breastfeeding
Theme 3: care & protection of OVC
Response:
• Support CBOs to provide economic,
nutritional & health resources to affected
families (including foster families)
• Breastfeeding
• Support initiatives to prevent abuse
• Succession planning, access to schooling
Summary actions suggested for
USG
1. Policy: revised approach to resource allocation
decisions in light of unprecedented challenge.
2. Invest in capacity and human resources in
affected countries (central and local govt.,
instns) to develop policy & implement
programs.
3. Scale up orphanhood prevention programs:
VCT, PMTCT+, safety nets, CBPs, etc.
4. Initiate and scale up programs for care and
protection of orphans (incl breastfeeding,
access to food and health care, preventing
abuse, assuring schooling, …)