We call upon governments, donors, and civil society to speak with one voice to tackle the exclusion faced by children and adolescents affected by HIV and AIDS, as well as their caregivers. Without dedicated support millions of vulnerable people will continue to be left behind in the pursuit of Universal Health Coverage (UHC) and Inclusion within the Sustainable Development Goals (SDGs).
2019 holds several key opportunities to make a difference. The debates on inclusion at the High Level Political Forum on the SDGs, the High Level Meeting on UHC, the UNAIDS Programme Coordinating Board meetings, the World Health Assembly, and the move towards UHC in many countries to name but a few. We urge you to champion the following key messages and recommendations in these, and in every opportunity.
We, the Members of The Coalition for Children Affected by AIDS (www.childrenandHIV.org) – an independent global body of thought leaders from across UN, donor, NGO and academic communities – are united behind them. They are based on the experiences and recommendations of a broad constituency of people living with or affected by HIV and AIDS.
- One size does NOT fit all. UHC does not mean a universal approach. Achieving inclusion in the pursuit of the SDGs means investing more in vulnerable people, alongside services that are available to everyone.
- Children and adolescents affected by HIV and AIDS are at greater risk of being excluded. They and their caregivers experience greater inequality, violence, psychological distress, discrimination, poverty, and stigma. This violates their rights and limits their ability to access services, overcome adversity, and to survive and thrive.
- Remove barriers to access. Children and adolescents affected by HIV and AIDS and their caregivers need laws, policies, and social and economic supports that foster inclusion and enable them to access and benefit from services.
- Community is key. Change happens in families and communities. Communities are more able to support excluded people who are beyond the reach of mainstream services. Building their capacity is an investment in long-term, sustainable change.
- Complex needs require comprehensive approaches. Tackling any one area of vulnerability on its own is less effective and less efficient. Combining support on health, education, protection, poverty, gender, and other areas, in a comprehensive programme, achieves more and uses fewer resources. This requires new ways of working and more investment in collaboration.
- Start early. What happens during pregnancy and in the first 1,000 days determines a child’s path through life. Children born into HIV affected households are more at risk of early developmental delays that limit their potential to learn, earn, and thrive across a lifetime. Young mothers and their infants are especially at risk. Tackling HIV during pregnancy and early childhood enables generations to start, and to stay, AIDS free.
- Listen and learn. Children and adolescents affected by HIV and AIDS, and their caregivers, are experts in their own inclusion. They should be supported to participate in making decisions that affect them, in delivering services to their peers, and in holding governments to account.
We call upon governments and donors to:
FUND. Broaden funding parameters, time frames, and programmes, and invest in the ‘invisible’ aspects of multi-sectoral collaboration such as joint planning, information sharing, case management staff and systems, and referral mechanisms.
PRIORITISE. Balance universal supports with targeted investment in children and adolescents affected by HIV and AIDS, including social protection, early childhood development, and psycho-social support.
DECENTRALISE. Direct more resources and powers to communities and community-based organisations, including those led by the children and adolescents who are themselves affected by HIV and AIDS.
LEGALIZE. Support the repeal of laws and policies that put vulnerable children, adolescents, and their caregivers at risk and exclude them from services and from society. This includes decriminalising sex work and homosexuality, and removing all age of consent restrictions on accessing services.
LEAD. Champion integrated, multi-sectoral, evidence-based national strategies for children and adolescents affected by HIV and AIDS as well as campaigns to build public support for inclusion.
PARTICIPATE. Formalize the participation of children and adolescents affected by HIV and AIDS, and their caregivers, in decision-making, accountability, and service delivery mechanisms and support them as a movement.
EXPLORE. Generate further evidence on what comprehensive approaches work best to enable children and adolescents affected by HIV and AIDS, and their caregivers, to thrive across the SDG outcomes.
REPLENISH. Invest in the replenishment of the Global Fund, which is at the forefront of delivering multi-sectoral comprehensive approaches worldwide.