A WORLD VISION JOURNAL OF HUMAN DEVELOPMENT Second Quarter, 2004 Alexandre Grangeiro National STD/AIDS Programme, Brazil Milly Katana Health Rights Action Group, Uganda Jim Yong Kim World Health Organisation Lieve Fransen European Community Late to the party This edition of Global Future has been prepared to coincide with the XV International AIDS Conference. Second Quarter, 2004 It took far too many deaths for the HIV/AIDS world to begin taking HIV/AIDS – where is hope? seriously.To see that it is more than a “health” issue (as critical as that is) and also an economic, political, The children’s suffering is neglected Ken Casey .................. 1 human rights, security and development issue. “If everyone does a little, much will be achieved” Alexandre Grangeiro.. 4 How could this have happened? For The ‘3 by 5’ Initiative – to save life and change history Jim Yong Kim .. 6 the same reason that, still, there is politicking and economising of the Towards a future and some hope Lieve Fransen .................... 8 issue – to the utter exasperation of A sleeping church awakes Christo Greyling ........................ 9 those closer to the suffering. Is enough being done to give hope? Milly Katana. ..................10 Denying the problem and stigmatising people living with HIV/AIDS have not helped.Thankfully, there are now Adolescents, gender and HIV Nafsiah Mboi .......................12 serious efforts to cease medieval- style “plague or punishment” Voices from the village Nigel Marsh .............................14 attitudes and respond proactively, with level-headedness and Disrupted lives Mark Connolly ..................................16 compassion. Faith-based organisations, including churches, Boys and men – key to reducing girls’ HIV vulnerability Sara Austin..17 have been waking up to their own complicity in this stigma problem, Mobilising the community Claudina Valdez and Ramón J Soto ............18 and transforming themselves into vital, values-driven players in the solution. Helping tumbleweeds grow roots Stuart Flavell ................. 20 Meanwhile, millions of children Women and AIDS in Mumbai – a programme evolves Reena Samuel.. 22 orphaned or otherwise made How Chilean children see AIDS Patricio Cuevas .................... 24 vulnerable by HIV/AIDS are on a frightening obstacle course – under ONE in the Spirit – against global poverty and AIDS Jenny Eaton .... 25 siege on all sides. If they have made it through pregnancy and birth without becoming infected themselves, endured lives of AIDS- Global Future is published quarterly by World Correspondence/donations should related poverty and then lost their Vision to encourage debate and discussion on be addressed to: development issues. mothers (often both parents), there’s Global Future a risk they will end up ostracised, Publisher Dean R. Hirsch World Vision International exploited or abused. Editor Heather Elliott 800 W. Chestnut Ave. Contributing correspondents: Kelly Currah, Monrovia, California 91016-3198 Anyone can foresee the dire Melanie Gow, Brett Parris, Matt Scott, Don Brandt, USA situation not too far down the track. Joe Muwonge, Siobhan Calthrop, Ruth Kahurananga, Telephone (1) 626-303-8811 This is why it is critical not only to Haidy Ear-Dupuy, Alan Whaites, Martin Thomas. Fax (1) 626-301-7786 shake off any remaining slumber now, but to empower and equip All opinions expressed in Global Future are e-mail: [email protected] those of the authors and do not represent the OR: younger generations to lead the way opinions of the World Vision organisation. in reducing the epidemic in what is, Articles may be freely reproduced, with World Vision acknowledgement, except where other copyright ultimately, their own future. is indicated. 6 Chemin de la Tourelle 1209 Geneva, Switzerland Is there hope? There is. But whether Global Future is distributed to many NGOs and non-profit organisations in developing countries. www.globalfutureonline.org we follow that path remains to be seen. Donations to support our production and mailing costs are very welcome (US$20 suggested). ISSN 0742-1524 _ Heather Elliott COVER DESIGN BY : FRIEND CREATIVE (Melbourne, Australia) / Cover Image by Jon Warren/World Vision: A seven year-old girl in Malawi, with her caregiver grandmother. This girl watched her mother die of AIDS in 2001. Her elderly grandparents wonder if they can stay strong long enough to give their beloved granddaughter a chance in life. The children’s suffering is neglected Ken Casey PHOTO - JON WARREN / WORLD VISION Some 130 children aged under five, up to 100 of them orphans, being fed donated maize by volunteers in a World Vision project in Chanjoka, Malawi HELEN1 IS 14 YEARS OLD AND AIDS. Her Gogo is the only adult left in It’s going to be a decade before we wants to be a secretary for a the family, and she needs as much care start to see the same scale of humanitarian organisation like the as she gives. orphaning in the rest of the world, but one that has helped people in her as infection rates continue to rise in Asia, village in Malawi. Helen’s grim determination to Latin America and Eastern Europe, it is succeed, and a little bit of help from inevitable that the misery will spread She walks 15 kilometres to get to volunteers organised and trained by further among the world’s children. secondary school each morning, World Vision, may make her dream carrying books and wearing clothes possible. For millions more children Tragic lesson provided by well-wishers. Each in Africa and increasingly around evening she makes the same walk the world, the picture is much Our most important lesson in Africa home and then must help her elderly, more troubling. is that we started far too late to tackle infirm Gogo (grandmother) to cook this overwhelming consequence of for her and a seven year-old cousin, Before long, one in eight of Africa’s AIDS. If we aren’t to make the same John.1 She has little time left for children will be an orphan: the mistake again, what we begin now homework or play. projection is 42 million orphans in must have a global application. Africa by 2010. At least half of these Helen’s parents died of AIDS in the children will have lost a parent to Those orphans have to go somewhere late 1990s. Then the uncle and aunt AIDS-related opportunistic infections. to live and eat. Like Helen, they are who took her in passed away.Recently And tens of millions more children’s often taken in by uncles and aunts, then her only surviving aunt, John’s lives have been made extremely by grandparents. As that generation widowed mum, also died painfully of vulnerable by HIV/AIDS. dies, they find themselves in the care Global Future — Second Quarter, 2004 1 of older children and strangers. of the list of responses to HIV/AIDS, heroes – actually, mostly heroines – is and often left off the list entirely. already providing an enormous Children in families that take in amount of care to Africa’s orphans orphans, and those where parents are We need to draw a line in the sand, and vulnerable children. Distant sick but not yet dead, suffer the same and say that this neglect of one of the relatives, aged village elders, informal kinds of stress and multiplied poverty least-regarded segments of humanity women’s associations, faith-based as the orphans themselves, creating a is an offence against human dignity. It groups, farmers’ co-operatives; all are category of “vulnerable children” that must stop. playing a part in rearing the children of is probably more numerous than that the HIV generation. of the orphans.The burden of care is It’s not only wrong, but also falling on families who are already the extraordinarily short-sighted. Providing These volunteer carers represent an poorest in the world. Only one family care and support for orphans and enormous network of goodwill that, if in 20 that is caring for these children vulnerable children is an essential provided with good organisation, receives help from any external source. investment in the security and stability training, and minimal resources, could of their communities and countries, as quickly multiply the level of quality well as their capacity to cope with care available. To avoid the same HIV/AIDS in the coming years. mistake, we must After 15 years of practical experience, apply globally the The plight of African children doesn’t listening and learning,World Vision has lessons from Africa fit within the political messaging of developed a broad strategy on many of the activist groups who are HIV/AIDS, called the Hope Initiative. loudest when HIV is on the agenda. Foundational to that is the promotion Since World Vision launched its first Drug companies can’t make money of Community Care Coalitions. specifically AIDS-related projects in from orphans. Under such pressure 1990, the organisation has studied the from powerful constituencies, donor This concords with our philosophy of impact of HIV in the countries where governments have focused most of development: we shouldn’t try to do we work, seeking the best ways that their resources on prevention and for communities what they can do for we and others can take on this treatment. themselves. Even now, and perhaps challenge. There’s a long way to go, especially now.Where local leadership It’s right to invest in prevention, especially in scaling up the best and volunteers are willing to act on treatment and care for the sick. practices that we’ve seen, but we’re behalf of their weakest neighbours, it Often the lives saved or prolonged are starting to produce and use some makes most sense to help them to do those of parents – thereby delaying or tools that seem to have an impact. just that. preventing orphaning. It’s possible World Vision is primarily a child- that, by effectively using enough In areas with little organised help but focused organisation, so it was natural resources, Africa can be saved from a lot of motivation, volunteer to begin there.