chapter  9
16 Pages

Children and AIDS as a driver of social protection DOUgLAS WEBB

The relatively rapid emergence of social protection as a public policy instrument in sub-Saharan Africa needs explanation, and the HIV and AIDS pandemic should be seen as one of the reasons, if not the principal reason, for its current centrality in responding to childhood deprivation. While it is conceivable that social protection would emerge as an inevitable construct in its own right, there is no doubt that AIDS and its social impacts have created a policy and resource environment that has facilitated the emergence of social protection and shaped its nature and potential application. AIDS-driven social protection policy and instruments are a conflation of two distinct but interrelated processes; those of AIDS impact mitigation and poverty reduction. This chapter will trace the recent history of this convergence, illustrating how changes in the way that AIDS impacts have been conceptualized and manifested have found fertile ground in debates concerning the nature of poverty reduction. Central to this convergence is the way that “vulnerability” as a concept has bridged the two debates and groups of institutional actors. This marriage was not arranged but has certainly proved convenient. Failed attempts at poverty reduction during the era of structural adjustment coincided in the mid-to-late 1980s with the emergence of a new development threat in the form of AIDS. Social protection in the twenty-first century in Africa is built on these two converging platforms. This alignment was also encouraged by emerging concerns over AIDS exceptionalism. These accusations of exceptionalism regarding AIDS financing over the past decade were (subconsciously, perhaps) anticipated by those engaged in supporting children affected by AIDS and, although this movement away from exceptionalism has at times been tense and hotly debated, we are close to a new consensus that represents a dramatic shift over the previous two decades. We need to examine the nature of this new consensus and how it emerged. The impacts of HIV and AIDS on children and wider society continue to evolve and the incidence of AIDS-related orphaning and its associated vulnerabilities have not yet stabilized. In sub-Saharan Africa, the most highly affected region in the world, the number of orphans from all causes is likely to top 50 million in the year 2010. Around one-fifth of these children are orphaned by AIDS. Highly affected communities in southern Africa especially are seeing

between one-third and one-half of their children losing one or both parents. The dynamism inherent in the HIV epidemic fuels an associated rapid evolution of the policy and program responses aimed at curbing the impacts of AIDS on communities, families and children. The over-arching policy response has broadened dramatically in its scope in the last two decades, since the first UNICEF-hosted meeting on “AIDS and orphans” in Italy in 1991. This evolutionary trend has taken the form of a movement away from responses characterized by individuation towards a systemic response addressing all vulnerable children in AIDSaffected societies. I have described this process elsewhere as a process of maturation or coming of age of program thinking: from the individual to the system.1