This report was commissioned by the Inter-Agency Task Team (IATT) on Children affected by HIV and AIDS' working group on National Plans of Action (NPAs). It presents a broad overview of progress made and lessons learned in mounting national responses for children affected by AIDS and other vulnerable children. Based on review findings, future actions are suggested to strengthen national responses and ultimately, improve outcomes for children. This study is based on a review of the literature, key informant interviews and expert consultation. Although an attempt was made to represent different regions and epidemiological contexts, selection of key informants and consultation was largely opportunistic. Based on availability of literature and key informants, Zimbabwe, India and Jamaica were looked at in more detail. In the future, standardised data collection from a purposeful sample of countries would provide a more comprehensive review of national responses and result in more rigorous findings and recommendations. The current review finds that although significant momentum for addressing the needs of children affected by AIDS and other vulnerable children has been generated at the global, regional and national level, complicated challenges persist especially in terms of defining the target population, capacity for implementation and monitoring and evaluation. A key finding is that wide variation across countries calls for more refined guidance from global and regional stakeholders.