The HIV antenatal survey of 1998 indicated that 3,6 million South Africans were HIV positive compared to 2,7 million people in 1997. This indicates that 1 out of every 8 adult is HIV positive and that ±1,600 new HIV infections occur daily in South Africa.

HIV/AIDS will have a selective impact on young and middle-aged adults who are usually potential supporters of and caregivers to children and older persons. Older persons will be left without the traditional support.

It is predicted that there will be a reduction in the number of potential mothers and fewer adults overall because of the reduced infant survival and adult AIDS mortality. In developing countries 42 percent of all adults infected, are women. Women are also infected at a younger age than men.

Presently the family structures are being disrupted and growing numbers of infants are being born with HIV-infection. Children are being orphaned by the death of the mother, or both parents due to AIDS. It is estimated that 5 percent of the child population is affected by HIV/AIDS and it is projected that this prevalence figure will increase to 16 percent at 2015.

Children orphaned as a result of parents dying of AIDS in KwaZulu-Natal are estimated to be 100,000. This figure could rise to 250,000 by the year 2005, if the current trends persist.

Due to the death of one or both parents, more and more child-headed households will emerge, particularly in communities were the traditional structures have been eroded. Young children will be caring for their younger brothers and sisters and older children will leave school in order to work to supplement the household income. This is quite often associated with the increase of movement of children onto the streets or onto commercial sex work.

The options of surrogate care for orphaned and abandoned children in South Africa have a limited capacity to cater for the needs of the entire population and will soon be swamped by a crisis associated with the increasing of the HIV/AIDS epidemic.

Unfortunately AIDS not only produces orphans in great numbers, but it kills and disempowers the very people who are best equipped to raise them, or to contribute to their upbringing.

The traditional safety-net for orphans, the extended family, will come under huge strain as a result of the loss of many breadwinners and caregivers.

The responsibility of providing for and raising the children will often fall on the shoulders of women suffering from AIDS, older people and older children.

Simultaneously, a sharp increase in unemployment, aberrant behaviour and poverty will occur in communities. Business and professional communities will be affected by losing skilled employees, customers, family members and confidence.

People living with HIV/AIDS and their families experience diverse psycho-social problems which include social stigma, rejection, isolation, radically altered roles, loss of control over and destruction of expectations for the future, fear of physical and mental disability and of imminent death.

Implications for welfare are the impact on social security, for example disability grants, child support grants, poverty eradication programmes and alternative care for children affected by HIV/AIDS. Effective and affordable community-based care and support models and targeted preventative interventions are a prerequisite in addressing this epidemic.

DEPARTMENT’S RESPONSE

As a response to the AIDS epidemic the welfare sector developed a Social Welfare Plan on AIDS which has five strategic focuses, namely,

a) Decline in the prevalence of HIV/AIDS through targeted preventative interventions.

b) Manage the impact of AIDS on social security.

c) Development of affordable community based care and support models.

d) Formalise strategic alliances.

e) Development of appropriate policy.

Developmental social welfare services to people infected and affected with HIV/AIDS are rendered in an integrated manner. No discrimination is taken place within service rendering. Examples of services are:

counselling and support services to infected and affected people

income generating programmes (especially women)

foster care placements

promotion of adoption of children who are infected

children’s homes linked with outreach programmes to the communities

the Make a Difference to Young People programmes have been launched to integrate model processes and practices and also to promote new initiatives around the country.

The "Women’s Partnership Against AIDS", which forms part of the overarching "Partnership Against AIDS", was officially launched by the former State President, Nelson Mandela, in Cape Town on International Women’s Day, 08 March 1999.

During the Moving Conference a pledge was developed, which highlighted the urgent need for the establishment of one stop service centres. Each province has been requested to indicate appropriate projects by means of business plans before the end of 1999.

However these services are not sufficient and should be extended. Intensive programmes should be launched to :

develop community-based systems in order to: