The Global AIDS crisis and its impact on children

Media contacts Amy Parodi 253.815.2386 (o) 253.709.3190 (c) Geraldine Ryerson-Cruz 202.572.6302 (o) 202.246.2432 (c)

Today, the estimated number of people living with HIV and AIDS nears 40 million — roughly the population of Spain. While AIDS is believed to have killed more than 28 million people, it has devastated the lives of millions more. More than 15 million children worldwide have lost at least one parent — if not both — to AIDS and related diseases like tuberculosis.

By 2010, the number of children orphaned by the disease is expected to exceed 25 million — slightly more than the population of Texas — according to the United Nations. The impact on these children, both before and after the deaths of their parents, is catastrophic. Children suffer the most, especially from the loss of their parents, teachers, community members, and peers. It's a tragic loss of key adults who once provided stability and were role models to their lives. Many children orphaned by this pandemic become malnourished, are forced to drop out of school, and are exploited for cheap labor.

Hakim, a 12-year-old orphan in Uganda, built his own hut to live in and must work as a porter to pay for his primary education. © 2007/Nigel Marsh/World Vision

Children as caretakers

Because poverty keeps many from access to health care and because of the stigma attached to AIDS, children often become their parents' primary — or only — caretaker. The time, energy, and financial resources necessary to care for dying parents takes its toll, and many children must leave school.

Educational and economic impact

The loss of educational opportunities for these children can be fatal. As their dying parents are unable to provide economically, and eventually pass away, children must often take their parents' places as family breadwinners. According to UNICEF, children who have lost their parents have substantially lower education levels than their counterparts with intact families. Without proper education, the opportunities to generate income grow sparser and more dangerous.

Children who have lost their parents to AIDS often are relegated to exploitive labor or the commercial sex trade to provide for their families. UNICEF reports that the majority of child prostitutes and street children in Zambia are orphans; in Ethiopia, orphans compose the majority of child domestic workers. Without the protection of their parents, orphaned children become especially vulnerable to sexual and physical abuse as well as exploitive working conditions.

Malnutrition and AIDS

Nutrition suffers as many people, particularly in hard-hit rural areas, are subsistence farmers. The physical rigors of farming often are too heavy for those with compromised immune systems. When health fails, so do crops — and a vicious cycle of hunger and sickness begins. The malnutrition that becomes fatal to sick parents also affects children and their development. Children affected by the combined impact of AIDS and malnutrition are less likely to thrive physically, emotionally, educationally, or economically.

Psychological impact on children

In addition to the physical and educational impact, children are often scarred psychologically as they face death within their own families on a regular basis. Compounding that trauma, many cultures stigmatize those living with AIDS — and their family members. Children of those infected with HIV often are alienated by extended families and communities. Even after their parents die, those who should care for them often turn them away for fear of further infection. The effect on children's mental health can be devastating, leaving them with symptoms of what we know as depression and post-traumatic stress.

Social Safety Net Failing

In hard-hit communities, where often an entire generation of parents has died from AIDS and related illnesses, the traditional social safety net has become strained. In many places, it has all but disintegrated. In some villages, only children and a generation of grandparents remain. The most vulnerable members of communities are left to care for themselves and each other.

Not only do grandparents find themselves caring for sometimes dozens of their children's children, many other households are run by children themselves — some as young as 11. UNICEF reports that 10 percent of households in Swaziland are headed by orphaned children. Many more of these children end up living on the streets of urban areas.

Among the regions of the world, the orphan crisis is worst in sub-Saharan Africa. According to UNICEF, in 12 African countries, it is expected that within the next three years, orphans will make up 15 percent of all children under 15 years old. Moreover, as the time between initial infection and death spans, often beyond a decade, the number of orphans will continue to rise, even in countries that are seeing infection rates decrease.

Care for these children — and support for their holistic well-being — will be a crucial difference between those who are able to overcome the loss of their parents and succeed — and those who don't.

Resources for Journalists

• AIDS Attitude Survey: Key findings, executive report, full survey results
• World Vision's work to fight global AIDS
• World Vision's advocacy on the AIDS issue