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Global orphan numbers would be falling without AIDS
United Nations Children’s Fund Zimbabwe (UNICEF)
July 13, 2004

BANGKOK, THAILAND - By 2010, sub-Saharan Africa will be home to an estimated 50 million orphaned children, and more than a third will have lost one or both parents to AIDS, according to a biennial report on global orphaning released today by USAID, UNAIDS and UNICEF.

Children on the Brink 2004 presents the latest statistics on historical, current and projected numbers of children under age 18 who have been orphaned by AIDS and other causes. The 2004 edition also stresses the importance of very distinct developmental needs that must be met as vulnerable children progress through early and middle childhood to adolescence.

In just two years, between 2001 and 2003, the report states, the global number of children orphaned due to AIDS has risen from 11.5 million to 15 million - the vast majority in Africa. In Asia, Latin America and the Caribbean, other regions covered by the report, orphan numbers have dropped by around a tenth since 1990.

"Parts of Sub-Saharan Africa are undergoing a tidal wave of orphaning, in varying degrees due to AIDS," UNICEF Executive Director Carol Bellamy said. "The report clearly spells out what's best for children - keeping their parents alive and healthy, ensuring that they get good educations, and strengthening the laws, policies and norms that protect children from exploitation and abuse."

The epidemic is wreaking havoc on a scale unimagined in sub-Saharan Africa. Home to two-thirds of all people living with HIV and three out of four people dying from AIDS, the proportion of children who have lost parents due to AIDS has risen from just under 2 per cent in 1990 to over 28 per cent in 2003. Since 2000, 3.8 million children have lost one or both parents to AIDS, and by 2010, 18.4 million children - more than one in three orphans - will have lost parents to AIDS.

"This report underscores the critical importance of caring for children affected by AIDS," said Dr. Anne Peterson, USAID's assistant administrator for global health. "That's why President Bush made caring for these children an essential component of his $15 billion Emergency Plan for AIDS Relief."

In 11 of the 43 countries in the region, more than one in seven children are orphans. In five of those 11 countries, AIDS is the cause of parental death more than 50 per cent of the time.

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 due to all causes in Asia, double sub-Saharan Africa's 43.4 million. Although the proportion of those orphaned due to AIDS is likely to remain small, the authors warn that even slight upward trends in prevalence
in mega-population countries like China, India or Indonesia could lead to much greater numbers of orphans due to AIDS.

"With 60 per cent 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," said Dr. Peter Piot, UNAIDS Executive Director. "To avoid having millions more children become orphaned due to AIDS, countries must do everything they can to prevent people from becoming newly infected in the first place."

A framework for the response
More than nine out of 10 children affected by HIV and AIDS in sub-Saharan Africa are living with a surviving parent, sibling or other relative. But these families, most of whom are not receiving any external assistance, are in urgent need of support, the report notes.

The 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 authors stress. Without protective laws, child welfare services, social mechanisms and a supportive community, children are at much higher risk of exploitation, abuse, violence and discrimination.

The report calls for the urgent development and expansion of family-based and community-based care for boys and girls who are living outside of family care. Placement in residential institutions is best reserved as a last resort when better care options have not yet been developed or as a temporary measure pending placement in a family, the report states.

The United Nations and many partner organisations have endorsed a framework of action to provide guidance to donor nations and the 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 lives of parents and providing economic, psychosocial and other support;
• mobilize 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, health care and birth registration;
• ensure that governments protect the most vulnerable children through improved policy and legislation and by channelling resources to communities; and
• raise awareness at all levels through advocacy and social mobilization to create a supportive environment of all children affected by HIV and AIDS.

Key to effective responses is the direct involvement of children and adolescents in planning and implementing efforts to mitigate the impact of AIDS in their communities, the report states.

"Children need more than inspiring words," said the authors of the report. "They need leadership that touches their lives directly. They need action that is taken to scale - action that grows out of a unified and targeted strategy that will protect, respect, and fulfil the hopes and dreams of all orphans."

More facts:

• In 2003, 2.9 million people died of AIDS and 4.8 million people were infected with HIV. AIDS is the leading cause of death for people ages 15 to 49.
• By end-2003, there were an estimated 143 million orphans (from all causes) ages 0-17 in 93 developing countries. More than 16 million children were orphaned in 2003 alone.
• In just two years (2001 - 2003), the global number of orphans due to AIDS increased from 11.5 million to 15 million.
• Some 5.2 million children in sub-Saharan Africa became orphans in 2003. In five countries in southern Africa, 15 per cent of all orphans lost one or both parents in that year; a similar number of children were living with chronically ill family members.
• Double orphans: AIDS is more likely than other causes of death to create double orphans - children who have lost both parents. Sub-Saharan Africa had almost as many double orphans in 2003 as Asia although Asia has about four times more children. Of the 7.7 million double orphans in sub-Saharan Africa, over 60 per cent lost one or both parents due to AIDS.
• Maternal orphans: In sub-Saharan Africa, where women have higher rates of HIV than men, maternal orphans now outnumber paternal orphans in five of the most affected countries. In the most affected countries of southern Africa, 60 per cent of orphans have lost their mother, compared with 40 per cent in Asia, Latin America and the Caribbean.
• Age structure of orphaning: The proportion of children who are orphans generally increases with age, and older orphans outnumber younger orphans. However, almost half of orphans are below the age of 12, and 12% of orphaned children 0-18 years of age are under 5. These are the most vulnerable children.
• Burden of care: Extended families are caring for more than 90 per cent of orphaned children. Today, 20 per cent of households with children in southern Africa are caring for one or more orphans. Orphans are also more likely to be living in female-headed and grandparent households.
• National responses: At the end of 2003, only 17 countries with generalized epidemics reported having a national policy for orphans and vulnerable children to guide strategic decision-making and resource allocation.

Regional statistics

• Sub-Saharan Africa is home to 24 of the 25 countries with the world's highest levels of HIV prevalence, and the fastest growing proportions and absolute numbers of orphaned children. Between 1990 and 2003, the number of children orphaned by AIDS increased from less than one million to an estimated 12.6 million. Nine out of 10 children living with HIV/AIDS are African, as are eight of every 10 children who have lost parents to AIDS.
  
  Orphans are concentrated in certain countries, reflecting broader trends in HIV prevalence and population. In five countries in southern Africa, 15 per cent or more of orphans lost one or both parents in 2003, the large majority of them due to AIDS. Equally high numbers of children are now living with chronically ill family members and will become orphans this year.
  
  Even without the impact of HIV/AIDS, sub-Saharan Africa already had the largest proportion of orphaned children. In 2003, 12.3 per cent (43 million) of all children in the region were orphans, nearly double the 7.3 per cent of children in Asia, and 6.2 per cent of children in Latin America and the Caribbean, who were orphans.
  
  Botswana has the highest rate of orphaning (20%). In 11 of the 43 countries in the region, more than 15 per cent of children are orphans. Of these 11 countries, AIDS is the cause of parental death between 11 and 78 per cent of the time.
  
  The impact of HIV/AIDS on mortality and the number of children orphaned by AIDS in sub-Saharan Africa will continue to increase through 2010. By then, more than one in five children will be orphaned in Botswana, Lesotho, Swaziland and Zimbabwe.
  
• Asia has the largest absolute number of orphans. Absolute orphan numbers are much higher in Asia, which has almost four times more children (1.2 billion) than sub-Saharan Africa (350 million). In 2003, despite lower prevalence rates, there were 87.6 million orphans due to all causes in Asia, double sub-Saharan Africa's 43.4 million.
  
  Orphan numbers have dropped by almost 10 per cent since 1990. But in some countries with large populations (such as China, Indonesia and Pakistan) the HIV/AIDS epidemic has only recently begun. If epidemics expand, the numbers of children orphaned by AIDS could grow dramatically.
  
  There are three countries in Asia where 10 per cent or more children are orphaned; Afghanistan - 12%; Lao People's Dem. Republic - 10%; and the Dem. People's Republic of Korea - 10%.
  
• Latin America and Caribbean - In 2003, there were 12.4 million orphans in Latin America and the Caribbean, a drop of nearly 10 per cent since 1990. In Haiti, which has an adult prevalence level of 5.6 per cent in 2003, over 15 per cent of all children are estimated to be orphans, more than double the regional average.

UNICEF Zimbabwe works both at national level and in 18 target districts in the country in areas of health, nutrition, water and sanitation, HIV/AIDS, education and life skills in efforts to ensure the basic rights of all children are realized.

For further information, please contact:
Liza Barrie, UNICEF, 0011 646 207 5178, lbarrie@unicef.org
Marixie Mercado, UNICEF, 0011 917 640 0184, mmercado@unicef.org
Madeline Eisner, UNICEF, 01 701 4626, meisner@unicef.org
Abigail Spring, UNAIDS, Thai mobile: +66 1 2500874, springa@unaids.org
Dominique de Santis, UNAIDS, Thai mobile: +66 1 2500882, desantisd@unaids.org
Roslyn Matthews, USAID, 202-712-0093, rmatthews@usaid.gov

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