Protecting the most vulnerable: Children living with HIV/AIDS
Statement delivered by Chris Lamb, Head, Humanitarian Advocacy Department, International Federation, to the Third World Congress on Family Law and the Rights of Children and Youth, Bath
22 September 2001



The International Federation of Red Cross and Red Crescent Societies, as the international organisation that groups together 177 National Red Cross and Red Crescent Societies all around the world, has a particularly strong interest in the theme of the Third World Congress, "International Cooperation for the Protection of Children".

In addressing this theme, the International Federation will pay special attention to children living with HIV/AIDS. This group is one of the most vulnerable groups in the world today, and the rights of the children it includes are among the most ignored, violated or uncertain.

The International Federation, in recognition of this special need, also planned its presentation to the Special Session of the United Nations General Assembly on Children which was to have been held in New York from 19-21 September 2001 on the same theme. The tragic events which forced the postponement of that Session are well known to all the world, and the International Federation has taken steps in other fora to ensure that its work, including importantly through National Red Cross and Red Crescent Societies, will help reaffirm the primacy of humanitarian values.

The International Federation also tailored its presentation to the 106th Session of the Inter-Parliamentary Union (Ouagadougou, 9-15 September 2001) addressing this theme and its particular relevance for Africa.

The theme of this Congress is remarkably close in spirit and substance to Final Goal 3.1 of the International Red Cross and Red Crescent Plan of Action, adopted by National Societies and Governments at the 27th International Red Cross and Red Crescent Conference in 1999. That Final Goal is "Improved health for vulnerable people based on strengthened cooperation between States and National Societies".

Allied to that, Final Goal 3.2 (concerning new initiatives to meet the needs of vulnerable people and reduce discrimination and violence in the community), contains in paragraph 10 a commitment by National Societies to pay special attention to the needs of children living in difficult circumstances, in particular street children. States also commit themselves, where appropriate, to support the actions of National Societies in meeting the needs of street children.

The commitments in the International Plan of Action relate to both governments, National Societies and the institutions of the International Red Cross and Red Crescent Movement. In addition to the Plan of Action, the International Federation is committed to the implementation of its Strategy 2010, a set of interrelated strategies which addresses the humanitarian challenges of this decade.

Strategy 2010 tackles the themes addressed by the World Congress from several fronts:

(a) influencing behaviour in the community with initiatives to oppose discrimination, including against people living with HIV/AIDS;

(b) supporting the provision of practical and emotional support to vulnerable people in the community.

Strategy 2010 also makes clear the role of National Societies to take a comprehensive approach to health and care structures when the formal system in their countries is unable to reach certain areas or groups of people. In such situations the National Society will advocate and support coverage by the formal systems, but concentrate its own attention on relevant health education and community based programs.

Taken together, the International Federation sees its function as fitting squarely within the program of the International Red Cross and Red Crescent Movement, endorsed by States,

"To improve the lives of vulnerable people by mobilizing the power of humanity".

It will be clear from these notes about the formal mandate of the International Federation, the problems faced by children living with HIV/AIDS are one of the most significant issues confronting it and its membership. This is why it is an honour for us to be able to bring our concerns to this Congress. The International Federation and its National Society members recognise that the Movement's work with governments, NGOs and all others concerned with the issue must be complemented by an equally strong work linkage with those in the world responsible for the protection of children and the adoption of "child-friendly" laws and policies.

The plight of children living with HIV/AIDS is of horrifying proportions in the world today. So much so that the International Federation has used every available international forum to stress the scope of the problem and seek commitments to addressing it in a practical fashion. As we said to the United Nations Commission on Human Rights in March 2001, we see our responsibility now as akin to the fighting of a war against HIV/AIDS. Our concerns are manifold, for HIV/AIDS has a direct and profound impact on such a wide range of the rights of children: especially the rights to protection, nutrition, health and education.

The effect of this tragedy is probably immeasurable. But it is important to try to take stock of some frightening statistics. World-wide, over the last 5 years, HIV/AIDS has killed an estimated 3.8 million children. More than 13 million children under the age of 15 have lost one or both parents to HIV/AIDS. By 2010, according to UNAIDS, one third of children under the age of 15 in sub-Saharan Africa will have been made orphans by HIV/AIDS. About 600,000 infants are infected each year as a consequence of mother-child transmission.
It is estimated that in the worst-affected countries as many as half of all today's 15 year olds will die from the disease.

The impact of the pandemic on communities and nations has been devastating. It has contributed to the destruction of economies and social structures. It has been treated by some communities and countries as a disease that should not be named and there remains a world wide problem of stigma, discrimination and exclusion of those affected by HIV/AIDS. This make is difficult not only to treat the disease but most importantly, to promote prevention education.

Its destructive effect has been compounded in some countries by the way it has struck countries which are either at war or on the brink of conflict. The sense of hopelessness experienced by people in these environments has aggravated the situation so much that for many the entire country seems to be on the brink of collapse.

For children and youth the problem is even more acute. At least 50% of all new infections occur in the 10-24 age group. More than 10 million people in this age group are living with HIV/AIDS today. They are doubly vulnerable because of the likelihood that they will either be orphans or in families without a breadwinner, and in addition suffer the effects of such stigmatisation and discrimination as to be virtually unable to live with dignity, let alone obtain the necessary food, material and emotional support and medical treatment.

Children living with HIV/AIDS are among the world's most vulnerable people, and often among the most ignored of the vulnerable.

Retrieving dignity - which means equipping them for a healthy life - for children living with HIV/AIDS is a central preoccupation for the International Federation and its member National Societies. This means doing everything possible to remove stigma and the ignorance on which it is based. It means working to keep families intact to the greatest extent possible: to ensure that children living with HIV/AIDS are as able as any other children to grow up in an atmosphere of love and care, and to benefit from the strength of their family and community environment.

It means coping with the issue of orphans having to drop out of school to become breadwinners or care for sick parents. It means addressing the education rights and needs of children when HIV/AIDS has taken away their teachers and closed their schools.

It also means that States and the remainder of the international community must be realistic and practical. It is not enough to talk about the problems of children living with HIV/AIDS, including of course, children orphaned by HIV/AIDS, without also addressing the surrounding issues which have aggravated their vulnerability.

The problems of children living with HIV/AIDS are exacerbated by other problems which HIV/AIDS itself has worsened: conflict, violence, malnutrition, homelessness, exploitation on a grand scale. It is the task of all those concerned with family law to take the fullest account of the special vulnerability of children in this situation when determining what measures should be in place to combat this vulnerability, and which ones should be used in particular circumstances. They can work, very productively, with their National Red Cross and Red Crescent Societies in addressing these needs. The experience available from this network is vast - the Philippines Red Cross, for example, assists 6,000 street children, and trains junior health workers to reach street children and help them to access essential health, nutrition and social services.

It is also important for national policy-makers to recognise that although the children are the victims, they are also a resource for the future. With appropriate education, care and support, children living with HIV/AIDS represent a means of reaching their peers and the wider community with a message about prevention and living healthy lives, and the importance of compassion. Red Cross and Red Crescent experience has shown that they are a vital component in the volunteer structure which is one of the most valuable arms of the battle against stigma. An example of a country where this structure works well is Zimbabwe, where Red Cross youth work as peer educators and teach other young people about prevention of HIV/AIDS and living safe and healthy lives.

Families, and their supporters in the family law system, must recognise this and work to strengthen the capacity of children and youth to be involved in this battle as active participants who can contribute to finding the solutions, not remaining just as victims on show. One of many countries where the National Red Cross Society plays an active part in this aspect of the struggle is Macedonia, where Red Cross youth are trained to operate an SOS telephone line which provides callers with information concerning drugs.

Much has been written about different aspects of the problem of children living with HIV/AIDS. One issue which might not always have received the attention it deserves is that of street children.

Family Court judges and practitioners around the world are familiar with the generality of the issue of street children. They leave home for a variety of reasons, usually related to poverty, family breakdown, the absence of safety nets, etc. Deprived of education, family support and security, street children are among the most vulnerable children in the world. They are also one of the groups at particular risk of abuse and infection by HIV/AIDS.

In some countries, street children are also a "product" of HIV/AIDS in the sense that they have been orphaned by the pandemic and find it necessary to work the streets to support their siblings. This problem will get progressively worse in the most affected countries, for the present generation of grandparental care-givers for HIV/AIDS orphans will not be replaced by a successor generation – that generation is already decimated by the disease.

National Societies have taken a variety of approaches to this issue, drawing on their particular local circumstances. Most National Societies have found, however, that there is little they can do unless they find a better way of sharing knowledge and experience, in particular on prevention and health education issues – and, critically, ways of eliminating stigma. The subject will be debated when the National Societies meet in November 2001 in the Movement's Council of Delegates, and the outcomes of this World Congress will be brought to their attention.

The International Federation's network of meetings involving National Societies, experts (including from governments), and practitioners provides an excellent forum for the sharing of knowledge on the best ways of addressing the problems of children and youth in the modern world.

This network has been expanded through the enhancement of an already valuable relationship between the International Red Cross institutions and the Inter-Parliamentary Union. This relationship has been extended to the search for ways of helping and supporting street children and children affected by HIV/AIDS. At the 106th Inter-Parliamentary Union Conference just concluded in Ouagadougou, Burkina Faso, the International Federation advocated for a special mention of the extreme plight of children affected by HIV/AIDS and their particular vulnerability, and the request that any activities aimed at providing care and support to them should be done within their communities, not in isolation.

It was particularly pleasing to the International Federation that these recommendation have been accepted and are reflected in the final resolution adopted by the IPU Conference. This resolution, as well as the above mentioned Plan of Action, are powerful tools that can assist both governments and Parliaments in supporting the service delivery and advocacy efforts of their National Societies on a country level.

For this reason, the International Federation and the National Societies can be expected to look closely at the International Children's Rights Protection Network being created at this Congress. Its advocacy functions seem likely to meld well into the overall advocacy purposes of the Red Cross and Red Crescent Movement, especially in that ICRPN will be advocating the ratification and implementation of the international instruments for the protection of children and the adoption of "child-friendly" laws and policies.

The International Federation hopes it will be possible for ICRPN to give particular attention to the vulnerability of orphans. The scale of this problem for communities where the HIV/AIDS epidemic is rampant is almost beyond belief. For example, UNAIDS estimated that there were 13 million children who had lost one or both parents to HIV/AIDS at the end of 2000. 11 million of these children are in Africa, and the number is rising every day. UNAIDS estimates that this number will almost quadruple by 2010, and will not peak before about 2020.

The task communities will face to maintain basic stability, built around families, is already straining them seriously in Africa. But it cannot be seen as a problem for Africa alone - the impact of HIV/AIDS is being felt increasingly in other parts of the world. For this reason it is vital that the family law structures of the world ensure that they are deeply involved to help entire communities unite to combat the epidemic. This involvement should include taking advice from the children themselves, recognising that they are the ones who whose future is so seriously jeopardised, and their capacity to learn about preventive behaviour and through it obtain confidence and control will have a profound impact on the development of their communities and nations.

It is hardly the International Federation's responsibility to address a Congress on Family Law about the way the law should be understood. It is, however, appropriate to note that the International Red Cross and Red Crescent Movement is guided by the the United Nations Convention on the Rights of the Child as it addresses the special vulnerabilities of children and youth.

The International Federation sees the Convention as particularly relevant to its work on the problems of children living with HIV/AIDS. In particular, however, we are guided by the primary consideration that must be given to the best interests of the child as we do our work. There are also many more specific articles that wse and the National Red Cross and Red Crescent Societies draw on for guidance in particular circumstances, and it is our hope that all those involved in Family Law will have the Convention with them at all times.

The International Federation wishes the World Congress the best of success with its future work on these issues, and with ICRPN. We will discuss the reality of ICRPN with the organisers at this Congress, and look forward to playing a constructive with you in building the rights of children and youth in the future.