Many countries are now having to deal with large numbers of children orphaned by HIV/AIDS. These and other countries will have to continue to do so for many years to come. Children and young people, and above all orphans, lack support and are susceptible. These include street children, children affected by conflict, disabled children, children affected by HIV/AIDS and girls. Despite the fact that there are large numbers of HIV+ children around the world, AIDS is often assumed to be a disease that kills adults.
Some people may occasionally think of ‘AIDS babies’, and children who have lost a parent or parents to AIDS – AIDS orphans – are sometimes in the media. However, since HIV, the virus that causes AIDS is commonly transmitted sexually or through drug use, people don’t really think of it affecting children. It does, though and millions of children around the world have had their lives damaged by HIV. All over the world, AIDS is responsible for an increasing number of deaths each year. Of the estimated 2. 8 million killed in 2005, around half a million were children aged below 15 years.
At the end of 2005, an estimated 2. 3 million children worldwide were living with HIV (UNAIDS/WHO 2006). Lack of HIV supervision facilities in many less-developed countries means it is difficult to produce accurate estimates, and the actual figures could be higher. What is clear is that very large numbers of children around the world are living with HIV and being killed by AIDS – something that is very hard for an adult to accept, harder still for a child who may still be too young to understand why they are dying.
In the year 2005, an estimated 700,000 children around the world were newly infected with HIV. More than 80% of these infections took place in sub-Saharan Africa, although Asia and the Caribbean are also seeing increases in the number of children infected with HIV. Most of these children i. e. as many as 90% acquired the infection from their mothers. Child death rates have almost doubled in Botswana and Zimbabwe since 1990, and many other countries that had seen child-survival rates rise, because of improved healthcare, are now seeing these rates fall again.
Worldwide, at least a quarter of children infected with HIV die before the age of one, up to 60% die before reaching their second birthday, and most die before they are five years old. By comparison, in higher-income countries, the transmission of HIV from mother to child is moderately rare, and in those cases where it does happen, a range of treatment options mean that the child can survive often into adulthood (UNAIDS Global Report, 2004).
In many countries, the HIV epidemic has not yet reached its peak, and so the number of children made susceptible by the disease is expected to increase. Moreover, because of the long incubation period of the disease (8–10 years), the adverse impacts of HIV/AIDS on children, households, and communities will linger for decades after the epidemic begins to wane. According to Levine and Foster (2000, cited by Foster and Williamson 2000), the mortality rates will not reach a plateau until 2020, which means that the number of orphaned children will remain high at least until 2030.
Simulations show that by 2010 the number of orphans and AIDS orphans will be 42 million and 20 million, respectively (UNAIDS 2002). Therefore by 2010 between 14 and 25 percent of all children in 11 out of 15 countries of eastern and southern Africa will be orphaned, of whom between 50 and 89 percent will be orphaned because of AIDS. In Zimbabwe, for instance, 22 percent (1. 3 million) of children are expected to be orphaned by 2010, and 89 percent of those children will be orphaned as a result of AIDS.
Despite the fact that there appears to be no definite relationship between the HIV prevalence rate and the percentage of orphans from all causes—mainly on account of the complex nature of causes i. e. AIDS, malaria, conflict, natural disaster, maternal death, and so forth, one clear pattern emerges: the proportion of orphans arising from AIDS increases with the prevalence rate. Countries and regions presently with a low prevalence of HIV can expect the proportion and number of AIDS orphans to increase in the near future as the prevalence rate rises.