There is currently much debate in South Africa on appropriate social security provision for children in the context of HIV/AIDS. The only provision currently made is for children orphaned by AIDS, in the form of cash grants. The problem is, however, much broader than this. According to the Children’s Institute and the Centre for Actuarial Research, University of Cape Town, “given the pervasiveness of poverty across South Africa’s child population, a social security system that directs interventions on the basis of children’s orphanhood mistargets crucial resources; is inequitable; … risks further overburdening the child protection system; and is not, as a whole, a cost-efficient way of adequately supporting the largest possible number of poor children who require assistance”. [Children in ‘need of care’ or in need of cash? Joint Working Paper of the Children’s Institute and the Centre for Actuarial Research, University of Cape Town. The issue to be addressed by this paper is whether or not the current social security provisions available to children are sufficient in terms of the state’s constitutional obligations in the context of South African HIV/AIDS pandemic. The possibility of a Universal Child Support Grant will be weighed against the current grant system and other alternatives, in order to evaluate the most appropriate mechanism to address the needs of children who are infected with as well as affected by HIV/AIDS.