Households burdened by an increasing number of AIDS orphans

By 2010 more than one in five children in Botswana, Lesotho, Swaziland and Zimbabwe will be orphaned by AIDS, a joint UN and US report warned on Tuesday. "Children on the Brink 2004" is the fourth edition of this biennial report, based on surveys conducted by the UN Children's Fund (UNICEF), the UNAIDS and the US Agency for International Development (USAID). Alarmingly, the studies found that 20 percent of households with children in Southern Africa were taking care of one or more AIDS orphans. About 78 percent of Zimbabwe's orphans and 77 percent of Botswana's had lost their parents to AIDS. Botswana, with 20 percent of its children orphaned, has the highest rate of orphaning in sub-Saharan Africa, followed closely by Zimbabwe with 19 percent. More than 15 percent of children in Lesotho, Zambia, Swaziland, Mozambique and Angola were orphans in 2003. About 63 percent of Swaziland's orphans had lost their parents to AIDS, as was the case with 60 percent of Zambia's orphans. UNICEF's executive director, Carol Bellamy, told a press briefing in Bangkok, Thailand this week that the number of AIDS orphans worldwide had shot up from 11.5 million in 2001 to 15 million in 2003. "The worst may still be ahead of us - far too many [parents] will die," she warned. "While not all orphaning is due to HIV/AIDS, orphaning remains the most visible, extensive, and measurable impact of AIDS on children ... After losing parents and caregivers, children have an even greater need for stability, care and protection ... HIV starts to affect a child early in a parent's illness, and its impact continues through the course of the illness and throughout the child's development after the parent's death," the report noted. According to the agencies' surveys, orphans are increasingly more likely to be living in households headed by females or grandparents. In Zambia, for example, female-headed households are twice as likely as male-headed households to be caring for double orphans - children aged under 18 who have lost both parents. "Female-headed households also take in more orphans than male-headed households. In South African households that have assumed responsibility for orphans, there are on average two double orphans in each female-headed household, while in male-headed households the average is around one," the report said. The burden on grandparents and older caregivers is increasing. The reported observed that in Namibia, "the proportion of double orphans and single orphans (not living with a surviving parent) being taken care of by grandparents rose from 44 percent in 1992 to 61 percent in 2000". In the absence of their primary caregivers, AIDS orphans are more susceptible to health risks, violence, exploitation and discrimination. The report highlights the strategic "Framework for the Protection, Care and Support of Orphans and Vulnerable Children Living in a World with HIV and AIDS", endorsed by all the UN agencies last year, as the "best hope for pulling orphans and other vulnerable children back from the brink". The Framework calls for strengthening the capacity of families by prolonging the lives of parents and providing economic, psychological and other support; mobilising and supporting community-based responses to provide long-term assistance to vulnerable households; ensuring that orphans and vulnerable children have access to essential services, including education, health care and birth registration; and ensuring that governments protect the most vulnerable children through improved policies and legislation. The report noted at end of 2003 only 17 countries said they had a national policy for orphans and vulnerable children.