The number of children orphaned by HIV/Aids has risen three-fold in six years to reach an all-time high of 13,4-million. Many are growing old before their years, looking after younger siblings, working to earn money and sometimes living on the streets, a major international report revealed on Wednesday.
India has the largest number of Aids orphans of any country in the world, standing at 1,2-million in 2001 and predicted to rise to two million in five years and 2,7-million in 10 years. It stands out for the magnitude of its problem that has, however, not been acknowledged either inside its borders or to the international community.
Detailed figures for India are left blank in the report, compiled by the United Nations agencies UNAids and Unicef and the United States government agency USAid, but can be extrapolated from the totals for Asia. The official explanation for the blanks by USAid was that “the data was not available”.
Because of India’s huge population, the proportion of its children orphaned by Aids is far lower than in smaller sub-Saharan Africa, where family structures are breaking down because of the deaths of a generation of parents.
The report, published at the 14th International Aids Conference in Barcelona this week, showed that Zimbabwe currently has an orphan rate of 17,6%, with more than three-quarters due to Aids. By 2010, it says, 21% of children will be orphans and 89% of these will be due to Aids. In Lesotho more than a quarter of all the children will be orphaned — four out of five from Aids.
“This is one of the most shocking reports released at this conference,” said Peter Piot, executive director of UNAids. “Aids has caused an orphan crisis.
“Children are taking on the role of adults in many places affected by HIV because a generation has disappeared. They can’t go through normal development. They have to work 40 hours a week. The very fabric of society is disappearing, with family structures crumbling.” Children also have to cope with the stigma of their parents having died of Aids and the suspicion that they may be HIV-positive themselves, he said.
Anne Peterson of USAid pointed out that in Uganda the number of orphans continued to rise for years after successful prevention efforts had brought infection levels down. “Even if we could stop the spread of HIV/Aids today, the numbers of orphans would increase for the next decade,” she said.
The report defines an Aids orphan as a child who has lost one or both parents to Aids, because if one is infected, it is likely the other will be too and will die soon.
On Wednesday charitable foundations launched a $50-million project to save mothers from death. Some HIV-positive pregnant women in poor countries are given an anti-Aids drug before giving birth, preventing them passing the infection to their baby. Tragically, most children saved by these mother-to-child-transmission (MTCT) programmes are likely to be motherless by the time they can walk.
The new project, led by Columbia University in the US and called MTCT-Plus, will guarantee that 10 000 mothers in eight countries will get the drugs for life that can keep them alive and well.
“This orphan crisis is a major reason for introducing treatment for adults on a wider scale,” said Piot. “I have never seen that in these simplistic cost-effectiveness analyses [of whether drugs are affordable in the developing world]. They haven’t even thought that there are orphans left behind when adults die.”
Earlier in the week the conference heard that the scourge of Aids will soon reduce the average life expectancy of babies born in 11 African countries to little more than 30 years.
In Botswana a baby born in 2010 will die on average before he/she reaches his/her 27th birthday. Figures compiled by USAid show a return to premature deaths unknown for more than a century.
Before Aids struck countries such as Botswana were prospering with an average life span of almost 75 years. But the infection rate in the country is now the highest in the world: 39% of adults are HIV-positive, which will kill them within nine or 10 years unless they receive expensive Western medicines.
The result for the blighted countries is that economies are being wrecked as not only will the adults die, the life expectancy of Aids orphans will plummet as they suffer from a health service undermined by too many demands being placed on it and depleted by the loss of nurses and doctors among the dead.
Five countries — Botswana, Mozambique, Lesotho, Swaziland and South Africa — will experience negative population growth by 2010, as the dying outnumber the babies being born.
Already Aids is the leading cause of death in Africa and the fourth in the world with 40-million infected globally. A report by UNAids last week predicted 70-million deaths by 2020 if major efforts are not made to stem the disease, which is fast spreading through Eastern Europe and Asia.
Several positive announcements, including breakthroughs in the development of possible vaccines by GlaxoSmithKline and US company VaxGen, came out of the five-day Aids conference. Glaxo said its alternative approach to combating the disease could be on the market in four years, while VaxGen worked on a five-year time frame.