Inter Press Service - November 25, 2003
Jacklynne Hobbs

"That is the plight of millions of profoundly vulnerable children who have lost one or more parents to this disease, as well as the long-term threat that the situation poses to peace and security - not only in Sub-Saharan Africa, but indeed worldwide."

Bellamy was speaking at the launch of a new report by her agency (UNICEF), entitled "Africa's Orphaned Generations". The 52-page document lists a number of chilling statistics about the toll AIDS has taken on the continent.

According to the report, "In 1990, fewer than one million sub-Saharan African children under the age of 15 had lost one or both parents to HIV/AIDS."

By the end of 2001 that figure had risen to 11 million. Worldwide, 14 million children have lost parents to the pandemic.

If current rates of infection continue, the number of AIDS orphans in Africa will spiral upwards - possibly to 20 million by 2010. This will comprise "about half the total number of orphans in the region", the report noted.

Almost three-quarters of people infected with HIV - more than 29 million -- live in sub-Saharan Africa.

"There used to be a saying that there are no orphans in Africa, because they were always taken care of by extended families," said Bellamy. "Well, that's what we continue to see. But...extended families...are becoming over-stretched, and in many cases overwhelmed."

The report says that households which have expanded to include AIDS orphans typically become poorer: "This is primarily because of the increased 'dependency ratio'...the income of fewer earning adults is sustaining more dependents."

"During 2002, in rural Zimbabwe," says the report, "households with orphans earned an average of 31 percent less than households without orphans."

There is also a growing trend for these households to be headed by women, and grandparents. However, widows risk having their property seized by family members or other individuals in the community.

According to the report, "At least one in four widows in (a) Uganda survey said they had lost property when their partner died, compared with one in 14 widowers."

Bellamy says the strain which is placed on the extended family unit is starting to be reflected in the lives of children in "numerous and very often devastating ways".

For one thing, AIDS orphans are less healthy than their counterparts. In certain households that are affected by AIDS, the amount of food consumed can drop by 40 percent or more, with obvious implications for stunting - and children's ability to resist disease.

The children of parents who die from AIDS-related infections frequently leave school to take care of their families - while AIDS orphans are also less likely to continue their education.

"In the United Republic of Tanzania," says the report, "the school attendance rate for non-orphans who live with at least one parent is 71 percent, but for double orphans it is only 52 percent."

In addition, AIDS orphans take on the stigma of HIV. They may ultimately find themselves living on the streets, subject to the worst kinds of exploitation: at best, cheap labour -- at worst, prostitution.

Graca Machel, a well-known advocate of children's rights who was also present at the launch, highlighted the life-long effect that watching parents die could have on a child. She also lamented the breakdown in the "chain of knowledge" that has seen traditions and survival skills passed from parents to children in Africa, for generations.

In another depressing development, African governments have largely failed to deliver on their pledge to put policies in place that will address the orphan crisis.

Kathleen Cravero, Deputy Director of the United Nations Joint Programme on HIV/AIDS (UNAIDS), told journalists that "...at the General Assembly Special Session on AIDS in June 2001, all governments in the international community promised that by 2003 there would be a policy in place in every government to deal comprehensively with the situation of children orphaned by AIDS."

"Today - just in Sub-Saharan Africa - 65 percent of countries don't yet have those policies," she added.

What the new UNICEF report aims to do is "encourage hope in the face of an epic disaster". Bellamy said, "Since we are a children's agency, we can never be only pessimistic - although there's a lot to be pessimistic about in this report. We also think one has to be committed to try to make a change."

The report recommends that action be taken in five "priority areas".

These include improving the capacity of families to care for orphans, through measures such as ensuring that parents live longer, by providing treatment for opportunistic infections and anti-AIDS drugs.

UNICEF believes it also critical for community networks like non-governmental organisations and faith-based initiatives to be supported, as these provide much-needed assistance to extended families.

As Machel noted, successful initiatives should be replicated on a wider front: "It's not enough to (keep) your small-scale initiative, no matter how positive it is...(in) your community. It has to be a nation-wide movement in which communities depend (on) one another, learn from one another."

Third on the report's list is ensuring that orphans get access to essential services around health and education.

It also calls for governments to protect children, and emphasises the need to create an environment which is generally supportive of children who are affected by HIV/AIDS.

While UNICEF's report makes a forceful case for greater action on part of governments, it may do little to sway the substantial number of countries in Africa which are dragging their feet on the matter of orphan policy.

This point was highlighted by Bellamy: "Frankly, much of the discussion around HIV/AIDS has been around prevention and it's been around treatment. And, I think it's been too easy for everyone - government leaders, others - to assume that these issues will be taken care of by that extended family approach."

"In the first two tranches of funding from the Global Fund for AIDS, Tuberculosis and Malaria, it (orphan policy) has not been a key part of any of those grants," she added, noting that this was probably the result of a failure by all parties - Fund and governments - to consciously address the orphan crisis.

Cravero said this flawed thinking could be changed: "We need to be focusing on this in what goes on at the Global Fund to Fight AIDS, TB and Malaria, with the World Bank money that comes in, with the new US government initiative - which clearly says that 10 percent of that initiative should be spent on programmes and actions for children."

The speakers were also at pains to emphasise the importance of international support for efforts in Africa. In response to a question about her feelings in the face of limited action thus far, Machel noted simply that she felt "outrage".

"Children cannot wait," she added. "Their rights cannot be postponed - and it is (our) responsibility...whether you are a community leader, whether you are a government official, whoever you are...to start acting in a vigorous manner today."

"Because these kids, one day, they'll look back and they will have very good reasons to ask: where were you? What have you done?" (END/AF/WA/SA/EA/HD/DV/HE/SD/JH/03)

031125
IP031119

Always watch for outdated information. This article first appeared in 2003. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2003. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .