Integrated Nataional Strategic Framework for Children Infected by HIV/AIDS

WELFARE PORTFOLIO COMMITTEE
17 November 1999
INTEGRATED NATIONAL STRATEGIC FRAMEWORK FOR CHILDREN INFECTED AND AFFECTED BY HIV/AIDS

Documentation received:
a) The implementation plan for the National Strategic Framework for children infected and affected by HIV/AIDS
b) Social Welfare plan on HIV/AIDS (transparencies)
c) Development of a national strategic framework for children infected and affected by HIV/AIDS
[email [email protected] for documents]

Present
Chair : Mr E Saloojee
17 members of Portfolio Committee, 2 apologies
3 departmental officials, including Mr A Theron
3 officials from the Presidency's National Plan of Action for Children

SUMMARY
A briefing was given by the Welfare Department and the National Plan of Action for Children on the overall welfare plan for HIV/AIDS and a specific integrated national strategic framework for children infected and affected by HIV/AIDS. The focus is strongly on collaborative inter-sectoral planning, care IN THE COMMUNITY, maximising the potential of ubuntu and the extended family, with support from state and civil society, and alleviation of the worst pockets of poverty. No specific AIDS grants are envisioned, but good access to general grants. Deadlines are very short.

MINUTES
Mr A Theron, Chief Director: Developmental Social Welfare Services, with input from his department and members of the National Plan of Action for Children, briefed the committee on the integrated national strategic framework for children infected and affected by HIV/AIDS, which had been developed in collaboration with all stakeholders at a consultative workshop held on 9/10 November.

The main thrust was to maximise the potential for care for the children WITHIN the community, by providing support, financial and otherwise, to families or alternative care-givers, and the community itself. It was stressed that HIV/AIDS is mostly found in conjunction with severe poverty.

There is strong motivation to collaborate inter-sectorally through the IMC (Inter-Ministerial Committee) on AIDS, and tight deadlines have been set to start implementation of the various components between now and 1 January. Home-based care projects were already being piloted in the 4 worst-hit provinces. Progress would be monitored by the NPA.

Concerns expressed referred to :
- The gap between the high-level consultation and the lack of consultation on the ground. The department gave reassurance that they were aware of this, and had waited to receive approval of the strategic framework before liaising with local groups.
- In the absence of a decision on notification, the dubious nature of any statistics used as a basis for planning
- According to medical reports, life expectancy with AIDS can be considerably extended by good nutrition, but this has not been mentioned in any pamphlets distributed
- A fallacious rumour that AIDS-sufferers would be isolated in separate villages was based only on a rural bias resulting from the distribution of the disease accompanied by extreme poverty.

It was emphasised by the department that currently there is no specific AIDS grant for adults or children, but there is no obstacle or discrimination to prevent them obtaining a general disability grant (on the basis of a medical report), or an old age grant, a child support grant, or most relevant of all, a foster care grant. There are plans for professional fostering services, with substantial additional grants to the foster parents, because it is felt to be both preferable and cost-effective to maintain AIDS orphans in the community, rather than in institutions. This has been successfully piloted through the juvenile justice system and is appropriate for replication in the HIV/AIDS field.

The additional funding needed to implement what was seen as a good long-term strategic framework would come from a number of sources. The programmes would need accurate costing. The IMC was recommended to consider central funding. In answer to a query the department stated they have an extensive but not totally comprehensive list of all registered and subsidised NGOs and CBOs providing AIDS-related services, and a website. A "rapid appraisal " of all community services, funded from overseas, was being finalised. The departments of housing and education should cover those aspects of orphans' needs. Both the Netherlands and Canadian Embassies had given generous support.

More concerns were:
- In the short term, because of its close and aggravating association with AIDS, the alleviation of poverty should be made a priority, with the worst pockets in the worst-hit KZN and 3 northern provinces being targeted for support to whole communities.
- Families whose breadwinners had been struck down should also be a priority.
- Professional families, though not needing financial support so urgently, needed emotional support.
- The trend seems to be for the economically-active parents to be hit by AIDS, and responsibility for the care of the children to devolve on elderly and often frail grandparents.
- Families need education and information to enable them to access the support services and grants available to them.
- There is a need for education and training of and through sangomas and traditional leaders
- Religious organisations should be involved - not only the SACC, but more particularly regional and independent churches
- The police services need to be trained to deal with traumatic bereavement
- There is emphasis on ubuntu and the support and encouragement needed by the community, the extended family and neighbours to enable them to take responsibility for hands-on help.
- Many primary health-care nurses have a negative attitude to CBOs offering helpful home-based care to sufferers.
- NGOs and CBOs providing services in this field should be supported with appropriate funding.
- We already have 250,000 AIDS orphans.

The concerns of the Portfolio Committee would be incorporated in the document being prepared for the IMC on AIDS for the end of this month. The Chairperson asked for another briefing in the first week of February, and also a financial report. It was noted that members need documentation in time to obtain mandates from their parties.