The National clap for South Africa

Chapter 7. Proposed action – by circumstances increasing likelihood of harm

7.1HIV/AIDS

It was estimated that by the end of 2000, 4.7 million South Africans, or one out of every nine would be HIV positive (Department of Health 2000). Many children are infected with the virus. Even if children are not infected with the virus, many are likely to be deeply affected through the disease’s impact on the adults in their lives.

HIV/AIDS can impact on child labour through two routes, either through its effect on households and communities, raising the probability of a child becoming a child labourer, or by raising the risks associated with child labour in general and sexual exploitation specifically.

The impact on households and communities can be devastating and may exert strong pressure for the involvement of children in work activities. This is particularly true in cases where children are orphaned by the disease. A recent study by the University of Cape Town estimates that the number of children who will have lost one or both parents to AIDS will peak in South Africa around 2014-2015, with 5,7 million children having lost one or both parents.¹ International research suggests that when orphans in the developing world constitute up to 2% of the child population, the children are generally absorbed into the extended family and community. In South Africa the percentage of orphans is expected to increase to between 9-12% of the child population by 2015. Where these children are taken into homes in the community, they may also be required to work for excessive hours, or to do other work inappropriate for their age within the household.

As the disease progresses in an individual, he or she will be less able to support his or her dependents. Thus, even before the parent suffering from AIDS dies children may effectively be orphans in economic terms since they are forced to care for the parent as well as having to support themselves on their own. Thus, children’s basic survival is likely to come under increasing threat as HIV/AIDS claims more and more South African parents.

The impact on children of the HIV/AIDS pandemic extends further than the impact on children’s families and households. Children’s access to education, for example, is likely to be negatively impacted as the disease spreads, infecting more teachers. Here, government’s challenge is also to ensure that the higher education system is able to produce teachers at a fast enough pace to replace those teachers who are sick or dying from AIDS-related diseases. Other countries in Southern Africa have already encountered this problem. In Zambia, for example, in 1998, teacher deaths totalled two-thirds of the number of newly graduated teachers. HIV/AIDS infected and affected teachers may also be forced to miss work due to their own or relatives’ illness, negatively impacting on the quality of education received by schoolchildren.

HIV/AIDS will result in an increase in the number of child-headed households. The children in these households need income, and many will work unless there are other forms of assistance. At present the main forms of assistance come from over-stretched communities and NGOs. Current policy prevents such households from accessing the child support and other grants.

Children affected by HIV/AIDS are likely to become more vulnerable over time, and it is likely that their vulnerabilities will be exploited by some in the community, sometimes under the guise of helping them.

In households where there are adults affected by HIV/AIDS, we can expect an increase in the incidence of children having to care for terminally ill people, and having to earn an income because breadwinners are ill or have died. This reduces their ability to further their education. It may also expose them to serious risks, such as where they are forced by circumstance to work on the streets or sell sexual favours.

To aggravate matters, the existing formula for allocating equitable share funds to provinces is based partly on the number of children within the age range in which children are expected to complete compulsory education. Many children may start school late or interrupt their schooling because of HIV/AIDS. This means the state will not pay a full contribution towards their first nine years of education. Schools require that children falling outside the age of compulsory education pay full fees, because the prohibition against excluding children from school due to non-payment of fees applies only to those still subject to compulsory education.

HIV/AIDS, and children infected and affected by the pandemic, were raised as priority issues at six of the provincial consultative workshops. The government's programme is to encourage orphaned, abandoned or impoverished children affected by HIV/AIDS to remain in their homes and communities, with the understanding that they will receive appropriate care and assistance, including education.

The National DE has embarked on the training of teachers and life skills coordinators to address the issue at a curriculum level. Audits of orphans and counselling are other important projects that the DE is embarking on. There is a widespread awareness campaign related to this issue at both provincial and national level.

The national DSD has developed detailed National Guidelines for Social Services to Children Infected and Affected by HIV/AIDS. Unfortunately, the document contains little, if anything, on child labour or child work.

Proposals are as follows:

Research should be done to determine the extent of child-headed households and AIDS orphans, and the effect that HIV/AIDS is likely to have on child labour, and to make recommendations regarding appropriate action. Lead institution: DSD; Secondary institutions: DL, DH*. New policy? Regarding child labour and child-headed households – elaboration of existing policy. Once-off cost: moderate. ILO funding: full research costs. Time line: to start within two years of adoption of policy.

The growing number of home-based care programmes could play a role in terms of children affected by HIV/AIDS. Fieldworkers for all home-based care programmes need to be trained to recognise the problems children face in HIV/AIDS-affected households, and link them up with the necessary assistance services. Government must find ways to work together with and support – financially and otherwise – the full range of home-based programmes. Lead institution: DrSD*; Secondary institutions: DPLG, LG, DH, NGOs. New policy? Elaboration of existing policy. Once-off cost: moderate. Recurrent cost: moderate. Time line: to be introduced within one year of adoption of policy.

The government has expressed a commitment to providing anti-retrovirals beyond mother-to-child-prevention and has recently completed a costing study. Provision of anti-retrovirals to adults to promote adult well-being and longer life would reduce the number of HIV/AIDS orphans, and prolong the period during which caregivers were healthy and could earn income and prevent children needing to work. The implementation of an extended programme around provision of anti-retrovirals thus needs to be speeded up as much as possible. Lead institution: DH. New Policy and cost? Policy already under consideration, and has been full costed.

Reconsider the education component of the equitable share formula for provinces and the age-related provisions for exemption from school fees. Lead institution: NT; Secondary institution: DrE. New policy? Yes. Costs: Redistribution rather than additional cost.

Relevant policy measures discussed elsewhere:

The most appropriate child-related grant regarding children affected by HIV/AIDS is an extended Child Support Grant (CSG) – see (12).