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V. National and International Responses

Human Rights Watch contacted government officials from Kenya, South Africa, and Uganda for this report, as well as officials from the World Bank, the United Nations Children’s Fund, and the Office of the Global AIDS Coordinator in the U.S. Department of State, which administers the five-year, $15 billion President’s Emergency Plan for AIDS Relief (PEPFAR).  We also reviewed policy documents and official statements from the governments of Kenya, South Africa, and Uganda, as well as from numerous international agencies.  Our interviews and other research showed that while governments and donors had generally recognized the issue of equal access to education for AIDS-affected children, they had barely begun to implement strategies to address it.

In 2004, the government of Kenya released an “Education Sector Policy on HIV/AIDS,” which called on the education sector “as much as possible, to assist OVC [orphans and vulnerable children], learners who are ill or with special needs so that they are able to continue with education.”¹²⁴  The policy specifically called on primary schools to “give special attention to factors that affect the performance of OVC and learners with special needs, and find ways to assist them.”  Kenya also announced in June 2005 a “Cash Subsidy Programme” similar to the system of foster child grants in South Africa, whereby parents or guardians caring for orphans would receive a stipend of Sh500 (U.S.$6.60)per month for each eligible child.  The government did not describe how it would prevent the abuse of this scheme by individuals seeking to exploit orphans for their eligibility for cash grants.  The program aims to reach 2500 children by November 2005 and as of June 2005 had received Sh40 million (U.S.$528,400) in funding from UNICEF.  When Vice President Moody Awori announced the program, she said, “There are about 10 million families in the country and if we give Sh500 to Sh1000 [U.S.$6.60-$13.20] a child, we will be able to end street children and other child problems.”¹²⁵

As of this writing, South Africadoes not have a national policy to address the needs of AIDS-affected children deprived of parental care.  In July 2005, the Department of Social Development announced it had drafted a plan to strengthen “local structures” to provide care and support to orphans and vulnerable children.¹²⁶  An official from the Department of Social Development in Gauteng Province, where numerous children were interviewed for this report, told Human Rights Watch that her department’s strategy was to expand funding for CBOs and provide technical assistance so they could “sustain themselves, either by raising funds or creating income generating activities.”¹²⁷  Unlike Kenya and Uganda, South Africa does have a formal system of foster care, however it has many flaws.  Among them are that the system reaches a tiny fraction of eligible children; does not generally benefit non-orphans whose parents are sick; creates perverse incentives for unscrupulous “caregivers” to take in orphans for financial motives; and imposes such cumbersome bureaucratic requirements that few people bother to apply for foster child grants.¹²⁸  A proposal to develop a single, streamlined grant for all needy children, regardless of orphan status, is being considered in the context of debates over a national Children’s Bill.  With respect to South Africa’s continuing policy of allowing schools to charge fees even for orphans, one recent report predicted that the government would continue levying fees as an essential source of income for schools, while meeting its constitutional obligation of free primary education by providing waivers for children who cannot afford to pay.¹²⁹

The government of Uganda does not provide cash grants to AIDS-affected children, but instead relies on CBOs—funded by the government as well as donors—to address the full range of these children’s needs.¹³⁰  In June 2005, the Ministry of Gender, Labour and Social Development issued a request for applications for thirteen grants totaling 1.3 billion Ugandan Shillings (approximately U.S.$800,000), one of the goals of which was to link orphans and vulnerable children to “essential social sectors” such as education.¹³¹  The grants were funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and reflected the priorities laid out in Uganda’s national policy and five-year strategic plan for orphans and vulnerable children, released in June 2005.  The request placed a particular emphasis on child protection initiatives, calling for proposals to assist local government officials and child advocates in “inspecting children’s homes, investigating reported cases of child abuse and defilement, and serving as advocates for and protectors of children.”¹³²

As noted above, most organizations providing services to AIDS-affected children in sub-Saharan Africa to date have been churches, women’s groups, and small CBOs, many of which rely on local donations, often from the poor themselves.  International donors such as the U.S. Agency for International Development (USAID), the United Kingdom’s Department for International Development (DFID), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank now spend some U.S.$6 billion on international HIV/AIDS programs each year, but these donors have only recently begun to develop comprehensive strategies to address the needs of AIDS-affected children.  Officials at these institutions are at this writing weighing the merits of numerous program interventions, including cash grants to needy families; encouraging institutional changes to make services, including schools, more accessible to all poor children including those affected by AIDS; and supporting CBOs that, among other things, can help identify children in especially difficult circumstances.  Officials at UNICEF and some large donor-funded nongovernmental organizations told Human Rights Watch that most CBOs were “unsustainable,” although this may be because these organizations encounter numerous funding bottlenecks imposed from the outside and because the best CBOs are unknown to these officials.  In Uganda, a country with a strong pre-existing network of CBOs, the U.S. government was funding a wide range of CBOs; however, the U.S. approach in South Africa was to fund large external agencies to provide CBOs with policy advice, technical assistance, and training.