Blame & Banishment - Médecins du Monde

Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia
with the difficulties of socio-economic change and transition. These constraints, combined
with widespread consumption of alcohol and drugs, reduced the capacity of many to protect
their children. For some children from troubled families, the streets became their home or
source of livelihood, and risk behaviours became a part of their daily lives. At their height,
these street children were estimated to number a staggering one to four million.
Today, while there are no reliable estimates on the numbers of children on the streets,
the vulnerabilities of children and families remain largely the same. The current economic
and political crises in the region have revealed fragile foundations. According to the World
Bank, 9 some 50.1 million people are now estimated to be living beneath the poverty line.
Social reforms have stalled and social welfare budgets are being cut back.
A difficult political inheritance
The second challenge of addressing the HIV epidemic in the region has been a political
legacy of authoritarianism and control. Faced with an epidemic that mostly affects socially
excluded populations such as drug users and sex workers, post-Soviet systems and mindsets
have found it difficult to tailor inclusive responses to meet the specific needs of marginalized
groups and those living with HIV. Rigid social controls have often led to denunciation and
blame of those who fail to conform, or who are caught up in systemic failures. In these
circumstances, the stigma and discrimination related to fear and ignorance about HIV find
reinforcement in official attitudes of intolerance, and in existing public prejudice against
those whose behaviour is seen as ‘anti-social’ or ‘immoral’. Children born to HIV-positive
mothers suffer the consequences of these prejudices, experiencing a much higher likelihood
than other children of being abandoned at a hospital, or being left to live in isolation at a
specialized care institution.
Negative attitudes and the denial of uncomfortable social realities lie at the root of children
and young people’s vulnerability to HIV infection and continue to be major barriers to
addressing the real needs of children and their families. Policies and programmes remain
strongly influenced by the legacy of the past and continue to ignore clear evidence about
what constitutes an effective response as well as the everyday realities of those affected
by HIV. As a result, opportunities for progress are being missed, allocation of resources
often fails to match needs, and interventions may even aggravate the problems they are
intended to alleviate.
Children and young people are being failed by this response.
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