Eleven-year-old Fortunate, 7-year-old Bright and 3-year-old Innocence, live in the most prosperous looking house in their village near the Mozambican border. The building was started by their father and when he died two years ago his wife used the insurance money to finish it off. But last year she too died of "the coughing," probably tuberculosis which so frequently accompanies HIV infection that the two are known as "the ugly sisters."

The children show the emotional destruction that is a by-product of HIV. They have none of the energy of childhood, their eyes are dull and they don't communicate much...Going home after school they are unable to get into the house that is nominally theirs. The key is kept by their grandmother who has moved in to look after them but she is out working her fields. The three children sleep together in one bed, and there is nothing else in their room. [The Guardian]

What is PEPFAR?

On July 30^th, 2008, the president signed into law the Tom Lantos and Henry J. Hyde Global Leadership Against  HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008 finalizing the bill that the Senate and the House passed just days earlier. The bill reauthorizes the President's Emergency Plan for AIDS Relief (PEPFAR) which was launched in 2003.

• The bill authorizes $48 billion over the next five years for global AIDS, TB and Malaria with malaria receiving nearly $5 billion, Tuberculosis receiving nearly $4 billion, the Global Fund to Fight AIDS TB and Malaria receiving $2 billion for the first year and then "such sums" as necessary in remaining years, and global HIV/AIDS programs to receive the remaining roughly $30 billion. (Two billion dollars were shaved off during the Senate consideration of the measure.)
• The 10 percent earmark of HIV/AIDS funding for Orphans and Vulnerable Children (OVC) was retained and broadened in the legislation, so that PEPFAR coverage will now extend to the care and support of orphans and ‘‘other children affected by, or vulnerable to'' HIV/AIDS. The legislation defines vulnerability of children based on the level of their vulnerability rather than the cause and this is a major improvement as in the past, children made vulnerable by another cause other than HIV/AIDS were being denied services.
• The bill authorizes roughly $3 billion for OVC over the next five years (2009-13) out of the AIDS portion of the bill and sets the goal of providing for 5 million children (PEPFAR is currently supporting 2.7 million). It also calls for the president to come up with a strategy to address the vulnerabilities and needs of orphans and children who are vulnerable to, or affected by, HIV/AIDS.
• In addition to the 10 percent set aside for OVC within PEPFAR, vulnerable children will benefit from the resources authorized in the bill for our U.S. contribution to the Global Fund to Fight AIDS TB and Malaria and from the nearly $5 billion in bilateral funding authorized for malaria control programs. Malaria is the biggest killer of children under 5 in Africa.

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Last updated 1 September 2009