15 million and counting: growing numbers orphaned by AIDS

Fifteen million children under the age of 15 have been orphaned by AIDS till date, reversing the effects of better health and nutrition standards worldwide, says a new Unicef report.

More than any other cause of death, AIDS is more likely to deprive children of both their parents. AIDS orphans face discrimination, on account of a parent dying from AIDS, abandonment, if relatives cannot or will not care for them, and the responsibility of caring for younger siblings. They may also be infected themselves. Deprived of guidance and education, they may be more vulnerable to violence and exploitation.

The facts

The proportion of children who lost parents due to AIDS has risen from just under 2% in 1990 to over 28% in 2003, says a new United Nations report. ‘Children on the Brink 2004’, a biennial report released by USAID, UNAIDS and the United Nations Children’s Fund (Unicef) , presents the latest statistics on the historical, current and projected numbers of children under the age of 18 who have been orphaned by AIDS and other causes.

Released on July 13 this year, to coincide with the International AIDS Conference in Bangkok from July 11 - 16, the report notes that in just two years, between 2001 and 2003, the global number of children orphaned due to AIDS rose from 11.5 million to 15 million -- the vast majority in Africa.

By 2010, sub-Saharan Africa will be home to an estimated 50 million orphaned children. W ith HIV infection rates rising and the disease taking 10 years to kill without treatment, a third of this number, or 18.4 million children, will have lost at least one parent to the disease, says the report.

“It is a tidal wave of children who have lost one or more of their parents,” says Unicef’s executive director Carol Bellamy. “Fifteen million globally, close to 12 million in sub-Saharan Africa alone,” she adds, saying, “It has the possibility of destabilising societies quite dramatically.”

In 11 of the 43 countries in sub-Saharan Africa, more than one in seven children are orphans. In five of those 11 countries, AIDS is the cause of parental death more than 50% of the time.

More than nine out of 10 children affected by HIV and AIDS in sub-Saharan Africa live with a surviving parent, sibling or other relative. These families, most of whom receive no external assistance, are in urgent need of support, the report notes.

The report notes that were it not for AIDS, the number of orphans worldwide would be falling, thanks to better healthcare and improved nutrition standards.

In Asia, Latin America and the Caribbean, other regions covered by the Unicef report, orphan numbers have dropped by around a tenth since 1990.

While HIV prevalence remains low, absolute numbers of orphaned children are much higher in Asia, which has almost four times more children. In 2003, there were 87.6 million orphans in Asia, double sub-Saharan Africa’s 43.4 million.

Although the proportion of those orphaned due to AIDS in Asia is likely to remain small, the authors warn that even a slight upward trends in prevalence in mega-population countries like China, India or Indonesia could lead to much greater numbers of AIDS orphans.

“With 60% of the world’s population, Asia could soon be faced with a serious orphan crisis unless it takes urgent steps to stop the epidemic in its tracks,” says Dr Peter Piot, executive director of UNAIDS. “To avoid having millions more children becoming orphaned due to AIDS, countries must do everything they can to prevent people from becoming newly infected in the first place.”

The global AIDS meet being held in Bangkok, Thailand, has focused on money, improving universal access to life-prolonging drugs and wrangling over whether abstinence or condoms is the best way to prevent new infections. Children’s activists argue that the plight of orphans is not getting the attention it deserves within the overall AIDS effort.

Activists and officials at the conference also called for increased funding to help all orphans, who are more vulnerable than other children to HIV because they often do not get the education they need to help prevent the disease.

“In some ways, orphans are one of the orphaned issues at this conference. What’s left in the wake of the AIDS pandemic is these kids,” says Dr Joanne Carter, legislative director of RESULTS, an international anti-hunger and anti-poverty group.

Protecting the parents

Given the high numbers, priority should now be given to providing surviving parents with free anti-retroviral drugs, says a Unicef representative.

Increasing the availability of anti-retroviral therapy and giving priority enrolment in free anti-retroviral (ARV) programmes to surviving parents would provide a “stronger and more forward-looking response” to the needs of all children orphaned and made vulnerable by HIV/AIDS, explains Martin Mogwanja, Unicef’s representative in Uganda.

“The availability of free anti-retrovirals in Uganda now provides an unprecedented opportunity to assure the survival of at least one parent who can remain alive to provide love and care for that child,” he adds. “Priority enrolment for these surviving parents must become embedded as policy in all anti-retroviral programmes.”

Family capacity -- whether the head of the household is a widowed parent, an elderly grandparent or a young person -- represents the single most important factor in building a protective environment for children who have lost their parents, the report’s authors stress.

A framework for global response

“This is a huge problem that doesn’t require huge resources, but it requires huge attention,” says Bellamy.

In keeping with this, the United Nations and many partner organisations have endorsed a framework of action to provide guidance to donor nations and governments of affected countries to respond to the urgent needs of children affected by HIV and AIDS. The key strategies are to:

Strengthen the capacity of families to protect and care for children by prolonging the lives of parents and providing economic, psychosocial and other support.
Mobilise and support community-based responses to provide both immediate and long-term support to vulnerable households.
Ensure access of orphans and other vulnerable children to essential services, including education, healthcare and birth registration.
Ensure that governments protect the most vulnerable children through improved policy and legislation, and by channelling resources to communities.
Raise awareness at all levels through advocacy and social mobilisation to create a supportive environment for all children affected by HIV and AIDS.

InfoChange News and Features July 2004