AIDS Creating Global 'Orphans Crisis'

Abandoned HIV positive babies Sifiso, left, and Rose, right, at the Cotlands home in Johannesburg, South Africa, Tuesday, July 9, 2002. UNAIDS top official for Africa on Tuesday welcomed the world's recent focus on fighting HIV, but called for greater commitment to stop the spread of the deadly virus. About 28 million of the 40 million people infected with AIDS live in sub-Saharan Africa, according to a U.N. report released last week, and the numbers show no signs of abating.
In another grim report on the evolution of the global AIDS pandemic, experts estimated Wednesday that the number of children in the developing world orphaned by the disease will increase from 13.4 million today to 25 million in the next eight years.

Several statistics recently published have shown that the global epidemic has just begun, but Dr. Peter Piot, executive director of the U.N. AIDS agency, said the orphans report was one of the most shocking to be presented at the weeklong International AIDS Conference.

"In 1990 we had less than a million orphans due to AIDS," said one of the report's authors, Karen Stanecki of the U.S. Census Bureau.

In 1995 there were more than 4.5 million children in the developing world who had lost either or both of their parents. In 2001 that figure stood at 13.4 million.

In 2005 there will be 20 million and by 2010 the toll will pass 25 million, Stanecki said.

"This is without doubt one of the most shocking reports that has been released at this conference, and so many things have been said here," Piot said. "It is an illustration of how AIDS has moved to a truly family disease. AIDS has created an orphans crisis and that word is really not an exaggeration."

Even if the spread of HIV could be stopped today, the number of orphans would continue to increase for the next decade, added Anne Peterson of the U.S. Agency for International Development, or USAID.

Another report released Wednesday, by the Swiss-based advocacy and research group Association Francois-Xavier Bagnoud, predicted an even worse scenario — as many as 100 million orphans by 2010.

The estimates by Neil Monk, a social scientist with that group, include many more children in the definition of orphan.

International agency estimates only count children up to the age of 15 because government statistics classify people in 5-year age groups and cutting off at 15 was simpler than trying to calculate the numbers that would include older teens. The age limit was not set because children 16 and older cannot be termed orphans, U.N. researchers said.

"We've used a figure because it is important to quote a figure because people just won't listen if you don't," Monk said. "We know the truth is we can't put an exact figure on it."

"The true figure is not the important issue. The issue is that however many children it is today, never mind by 2010, we are not providing care and support for all of them. And do we really need to know the precise figure to provide this?" Monk said. "Do we need to be able to count the number of hugs that a child needs in order to be able to give them? Of course, the answer is no."

Dr. Helene Gayle, who heads AIDS programs at the Bill and Melinda Gates Foundation, said that whichever approach is taken to try to quantify the problem, it's important to be clear about how orphans are being defined.

"The bottom line is there will be tens of millions, perhaps hundreds of millions, as time goes by," she said. "What's needed are creative solutions, particularly ways to keep children in as normal a home environment as possible," Gayle said.

"Early on, people were talking about building huge orphanages. That's probably not going to be a reasonable solution, but are there ways to support extended families or other community members that are willing to take on children who have been orphaned?"

Gayle said countries need national plans to examine the needs of their orphans and to identify which organization are best suited to deliver.

Two years ago, three separate agencies produced reports predicting the size of the future population of AIDS orphans and each offered different predictions.

Part of the problem was that there are several ways to define an orphan. The classical definition is a child who has lost both its parents. However, children who have lost only their mothers are also sometimes considered orphans, and more recently, children with dead fathers have been included.

The latest study is a consensus report compiled by USAID, the U.S. Census Bureau, the U.N. AIDS agency and the U.N. children's agency and represents a more comprehensive look at the problem.

It offers estimates for three types of orphans — children aged 15 or younger living without mothers, those without fathers and those with no parents — as well as overall figures for children who have lost one or both of their parents.

The figures do not include the estimated 3 million children afflicted with HIV infection.

The report covers 88 countries in the developing world, where the majority of AIDS orphans are.

The U.N. AIDS agency estimates that outside the developing world, there are another 600,000 AIDS orphans, bringing the worldwide total to 14 million. There are no predictions for AIDS for how the orphan problem will evolve in the rich nations over the next eight years.