Children on the brink 2004 -- Key Messages and Facts

Key Messages

AIDS is undermining the rights and well-being of children

The impact of the epidemic is seen most cruelly in the mounting numbers of children orphaned and made vulnerable by the epidemic. Millions are growing up without parents; millions more are in households with sick and dying family members. More than 2.5 million children were living with HIV in 2003.

AIDS threatens child survival and development

The sickness and death of parents due to AIDS affect infants, children and adolescents in clearly distinct ways. Efforts to provide care and support to orphaned children must reflect an understanding of the different stages of development and changing needs of infancy, childhood and adolescence.

The family is a child’s first line of protection from abuse and exploitation

Every effort must be made to keep HIV-positive parents alive, and to support affected families in protecting and providing for children. This is the best way to ensure that orphaned children are enrolled in school and have access to shelter, good nutrition, health and other social services on an equal basis with other children.

Children in sub-Saharan Africa have been hardest hit

Even prior to HIV/AIDS, sub-Saharan Africa already had the largest proportion of orphaned children. The region is home to 24 out of 25 of the world’s highest prevalence levels, and three out four people dying of AIDS. Rates of orphaning are now steepest and fastest-growing in areas with the highest HIV prevalence levels; numbers will continue to swell over the next decade as HIV-positive parents become ill and die of AIDS.

Global orphan numbers would be falling were it not for AIDS

While orphan populations are increasing in sub-Saharan Africa, in Asia, Latin America and the Caribbean, other regions covered by the report, orphan numbers have dropped by around a tenth since 1990. However, in such mega-population countries like India, China, or Indonesia, even minimal increases in HIV cases would easily translate into millions of orphans.

Massive action at all levels is critical

Colossal gaps remain between what has been, and needs to be done to protect the rights of orphans and vulnerable children. More than 90 per cent of the children affected by AIDS are living with a surviving parent, sibling or other relative, and require assistance. Efforts to help children affected by HIV/AIDS should be directed toward the communities most affected by the epidemic.

Basic 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 aged 15 to 49.
  • By the end of 2003, an estimated 143 million orphans (from all causes) aged 0-17 were living 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 generalised epidemics reported having a national policy for orphans and vulnerable children to guide strategic decision-making and resource allocation.

Regional Satistics

  • 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.

Read more about the Children on the Brink 2004 report in our Press Centre.

Read Understanding AIDS in the Winter 2003 issue of Say Yes. See Programmes 2001-2005 for more information about UNICEF Turkey’s HIV/AIDS Prevention Programme for Young People.

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