The research reviewed and the current responses identified in this paper show that at local, national and international levels there are gaps in programming and policy to engage ideas and mobilise resources to address the needs and experiences of very young children infected/affected by HIV and AIDS. Chapter one identifies some key areas where the lives of very young children are affected by the pandemic. Chapter two reveals that HIV and AIDS and early childhood development (ECD) programming has shown a limited response so far. Finally, in Chapter three, conclusions are drawn that indicate that services are required urgently to support very young children both directly and through the families and communities in which they live. (Lists 9 resources and 11 online resources.)