THE U.S. GOVERNMENT SPECIAL ADVISOR FOR ORPHANS AND VULNERABLE CHILDREN FIRST ANNUAL REPORT TO CONGRESS, AUGUST 2007 HIGHLY VULNERABLE CHILDREN: CAUSES, CONSEQUENCES AND ACTIONS COVER PHOTO: PETER BENNETT/IDRC THE U.S. GOVERNMENT SPECIAL ADVISOR FOR ORPHANS AND VULNERABLE CHILDREN FIRST ANNUAL REPORT TO CONGRESS, AUGUST 2007 HIGHLY VULNERABLE CHILDREN: CAUSES, CONSEQUENCES AND ACTIONS TABLE OF CONTENTS Letter from the Special Advisor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ii Abbreviations and Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iii Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Chapter I: Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Chapter II: USG Activities for Highly Vulnerable Children . . . . . . . . . . . . . . . . . . . . . .9 Chapter III: Progress in Implementing the Strategy for Highly Vulnerable Children . . .21 Chapter IV: Plans for the Coming Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 Annex 1: Matrix of USG Assistance to Highly Vulnerable Children by Cause of Vulnerability and Program Purpose . . . . . . . . . . . . . . . . . . . . . . .32 Annex 2: NGO Comments to the Draft PL 109-95 First Annual Report to Congress FY 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 Annex 3: Programs for Highly Vulnerable Children by Agency . . . . . . . . . . . . . . . . . . .37 Annex 4: Sources for Textboxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65 HIGHLY VULNERABLE CHILDREN: CAUSES, CONSEQUENCES AND ACTIONS � i August 2007 Dear Friend: Disease, conflict and violence, natural disaster, and severe economic strife leave millions of the world’s youngest people without parents or caregivers. Globally, an estimated 143 million children in the developing world have lost one or both parents, while an additional larger number of children are highly vulnerable. As such, they face serious risks to their survival and well-being. In response to this growing crisis, President George W. Bush on November 8, 2005, signed into law the Assistance for Orphans and Other Vulnerable Children in Developing Countries Act (Public Law 109-95), landmark legislation requiring the U.S. Government (USG) to devise a single, comprehensive strategy for addressing critical needs among the developing world’s collective of highly vulnerable children. Less than two years have passed since the inception of the law, and today it is my privilege to submit to you the first annual report on implementation of PL 109-95, as required in Section 3.135 H of the legislation. PL 109-95 and the role of Special Advisor draw immediate attention to this unprecedented global crisis and demand coordinated action that is swift and effective. Indeed, much has occurred in a relatively short period of time. • In fiscal year 2006 alone, the United States responded to 54 disasters in 39 countries affecting at least 79 million children. • The United States also responded to conflict-related emergencies affecting more than 20 million children. • Most recently, the Office of the U.S. Global AIDS Coordinator noted in its March 2007 annual report that 2 million orphans received HIV/AIDS care and support in fiscal year 2006, up from 1.2 million orphans in fiscal year 2005. While our work is still in the beginning phases, the efforts involved over the past 18 months have been remarkable. We are maximizing the best, most complementary resources within the USG; are coordinating closely with partners and the international community; and are in the midst of identifying pilot programs to scale up for expanded reach and impact. Most importantly, we are championing the healthy development and human dignity of young people most in need. U.S. leadership is making a tremendous difference in the lives of highly vulnerable children in the developing world. Thank you for your support in this charge. Respectfully, S. Ken Yamashita S. Ken Yamashita, Ph.D. Special Advisor for Assistance to Orphans and Vulnerable Children ii � FIRST ANNUAL REPORT TO CONGRESS FY 2006 ABBREVIATIONS AND ACRONYMS AIDS Acquired Immune Deficiency Syndrome ART Antiretroviral Treatment ARV Antiretroviral Drug BRYCS Bridging Refugee Youth and Children’s Services CDC Centers for Disease Control and Prevention CoCom Combatant Commanders CRS Catholic Relief Services CSGP Child Survival Grants Program CSHGP Child Survival and Health Grants Program DCHA Bureau for Democracy, Conflict and Humanitarian Assistance DCOF Displaced Children and Orphans Fund DHS Demographic and Health Survey DOD Department of Defense DOL Department of Labor DOS Department of State EI Education Initiative FFE McGovern-Dole International Food for Education and Child Nutrition Program FFP Office of Food for Peace FIC Fogarty International Center FVA Bureau for Food for Peace and Voluntary Assistance FY Fiscal Year GH Bureau for Global Health G/TIP Office to Monitor and Control Trafficking in Persons HHS U.S. Department of Health and Human Services HIV Human Immunodeficiency Virus HVC Highly Vulnerable Children IATT Interagency Task Team ICRC International Committee of the Red Cross IDP Internally Displaced Person IeDEA International Epidemiologic Databases to Evaluate AIDS ILAB Bureau of International Labor Affairs ILO International Labour Organization IMPAACT International Maternal Pediatric Adolescent AIDS Clinical Trials Group HIGHLY VULNERABLE CHILDREN: CAUSES, CONSEQUENCES AND ACTIONS � iii IO International Organization IOM International Organization for Migration IPEC International Program on the Elimination of Child Labour IPHD International Partnership for Human Development IRC International Rescue Committee M&E Monitoring and Evaluation NGO Nongovernmental Organization NICHD National Institute of Child Health and Human Development NIH National Institutes of Health OCFT Office of Child Labor, Forced Labor, and Human Trafficking OFDA Office of U.S. Foreign Disaster Assistance OGAC Office of the U.S. Global AIDS Coordinator OHA Office of HIV/AIDS ORACLE Opportunities for Reducing Adolescent and Child Labor Through Education ORR Office of Refugee Resettlement OTI Office of Transition Initiatives OVC Orphans and Vulnerable Children PCI Project Concern International PEPFAR President’s Emergency Plan for AIDS Relief PL Public Law PLWHA People Living with HIV/AIDS PMTCT Prevention of Mother-to-Child Transmission PRM Bureau of Population, Refugees, and Migration PVC Office of Private and Voluntary Cooperation PVO Private Voluntary Organization TB Tuberculosis UN United Nations UNAIDS Joint United Nations Programme on HIV/AIDS UNDP United Nations Development Program UNHCR United Nations High Commissioner for Refugees UNICEF United Nations Children’s Fund UNRWA United Nations Relief and Works Agency URM Unaccompanied Refugee Minor USAID United States Agency for International Development USDA United States Department of Agriculture USG United States Government WFP World Food Program iv � FIRST ANNUAL REPORT TO CONGRESS FY 2006 EXECUTIVE SUMMARY USAID/KAUKAB JHUMRA SMITH Second-graders in Pak Gali Boys School in Poonch District, Pakistan, were some of the first students to use new tent classrooms provided by USAID after the devastating October 2005 earthquake. Outfitted with desks and chairs, the classrooms helped schoolchildren re-establish normal routines after the quake. HIGHLY VULNERABLE CHILDREN: CAUSES, CONSEQUENCES AND ACTIONS � 1 “The Assistance for Orphans and Other Vulnerable Children in Developing Countries Act of 2005” (PL 109-95) requires that annually, “the President shall transmit to the appropriate congressional committees a report on the implementation of this Act and the amendments made by this Act.” The objective of United States Government (USG) assistance to highly vulnerable children in devel­ oping countries is to open up opportunities for them to lead healthy, productive lives. Addressing their urgent humanitarian needs – a necessary first response – will not in itself improve their long-term prospects or prevent increases in the number of highly vulnerable children in the future. For this reason, USG assistance addresses immediate consequences of vulnerability through direct service delivery. It addresses causes of vulnerability through activities that employ diplomacy and policy and expand our knowledge through research, demonstration, D and information dissemination. Finally, it addresses the USAI ability of families, communities, and governments to Children in South Africa. care for their children and improve their future well­ being through capacity building and through integration • Capacity building: The Department of Labor’s Bureau of programs for highly vulnerable children with other of International Labor Affairs, in cooperation with the development programs. The USG strategy recognizes International Labour Organization and the Government that broad-based development programs that increase of Ghana, helped strengthen government capacity at community growth and resilience are critical for a national and district levels. As a result, a Child Labor longer-term, sustainable response, because they help to Unit within the Ministry of Labor was established, create an environment in which families and communi­ and reducing child labor is now a component of ties can care for the most vulnerable and reduce future Ghana’s Poverty Reduction Strategy. Projects endorsed vulnerability. by national and district governments worked to eliminate child trafficking and abusive child domestic labor. This first annual report on USG implementation of PL 109-95 describes the significant range of activities con­ • Policy, diplomacy, advocacy: In its 2006 Trafficking ducted by various USG agencies to protect and support in Persons Report, the Department of State was able children made vulnerable by a variety of causes. In many to expand its analysis of trafficking and government cases, activities are implemented by nongovernmental efforts to combat it to 149 countries – seven more organizations (NGOs) and in partnership with host than in 2005 – as a result of stronger government countries or other donors. Cooperation among USG response and more public awareness campaigns. agencies, NGOs, and international partners enables the USG to engage with them in pursuing coherent global • Research and demonstration projects: Research by policies and approaches to address the causes and special the Centers for Disease Control and Prevention on the needs of highly vulnerable children. Some examples: dangers of landmines and unexploded ordnance, carried out in collaboration with the Landmine Survivor • Service delivery: With HIV/AIDS funds and Food Network, found that unexploded ordnance is even a for Peace Title II food resources, Catholic Relief more serious public health threat in Afghanistan than Services provided nutrition and HIV/AIDS prevention landmines, with children and adolescents being at education, food distribution, and psychosocial support highest risk. As a result, landmine risk education and counseling to 20,000 children orphaned or made programs now focus on the hazards due to unexploded vulnerable from HIV/AIDS in Kenya. ordnance for children and landmine hazards for adults. 2 � FIRST ANNUAL REPORT TO CONGRESS FY 2006