United Press International - Wednesday, July 10, 2002
Michael Smith, UPI Science News

Both forecasts provided grim images of children struggling to care for younger siblings without an adult's care and others without homes roaming the streets in search of food and clothing or drifting into crime and prostitution.

At present, there are more than 13.4 million children in the three regions who have lost one or both parents to AIDS, according to a report jointly issued by two United Nations agencies and the U.S. Agency for International Development. That figure is up from fewer than 4.5 million in 1995, said Karen Stanecki of the U.S. Census Bureau, who helped prepare the report for USAID and the U.N. A "child" in the report is anyone under 15.

Stanecki told United Press International there currently are more than 500,000 AIDS orphans in North America, Europe, and Australia and New Zealand, but she did not make any projections for those regions. She said the report is a "conservative analysis" that easily could be proved wrong if the AIDS epidemic -- whose toll stood at 40 million at the end of 2001 -- takes a turn for the worse.

For example, in some highly populated Asian countries, Stanecki said, "the epidemic is just taking off" and because AIDS can take years to kill its victims, a new tidal wave of orphans could be in the offing.

"This is without doubt one of the most shocking reports released at this conference," said Peter Piot, executive director of the United Nations Joint Program on AIDS. "Children are now taking up the role of adults," he said. "The very fabric of society is disappearing and family structures are crumbling."

A competing report, issued by the Swiss humanitarian agency Association Francois-Xavier Bagnoud, said the numbers are being underestimated because the United Nations report does not include young people 15 and over.

"UNAIDS is excluding too many people for the sake of their statistics," said the group's research officer, Neil Monk. He added that AIDS workers should use "the highest possible number" in order to mobilize action to solve the problem.

Monk said his estimate is based on figures from both the United Nations and USAID, and on his own research in both Uganda and India, in which he studied household composition.

Stanecki told UPI her figures do not include children older than 15 because population estimates are broken down into five-year sections, but she agreed the arbitrary cut-off probably excludes many teenagers over 15 who still face all the problems of their younger counterparts. Despite that, she said, "we believe the numbers released today represent the best estimate" of the situation.

Anne Peterson, USAID's assistant administrator of global health, said the figures are the "broadest and most comprehensive" available. With 34 million orphans, Africa has the greatest proportion of children who are orphans from all causes, including famine and war. But aids orphans now make up one in three and by 2010, 20 percent of 42 million African orphans will have lost a parent or both to AIDS.

Asia has more orphans -- 65 million -- the report states, but only 2 percent have lost parents to AIDS. Even a small increase in the AIDS rate in that region would send the number of AIDS orphans skyrocketing, however.

Stanecki told UPI the number of AIDS orphans will continue to rise for years even where the epidemic is being brought under control. For example, after a decade of concerted prevention efforts in Uganda, she said, "only now are we beginning to see a decline in AIDS orphans."

By contrast, in countries such as South Africa, where the epidemic is still out of control, she said, the number of AIDS orphans is exploding, from fewer than 1,000 in 1990 to 61,000 in 1995, and to 662,000 in 2001. By 2010, she said, there will be 1.7 million.

Part of the world's response to the situation must be to improve access to basic health care and education, said Carol Bellamy, executive director of the United Nations Children's Fund. She added it will be important to shelter orphaned children from stigma and harassment. "Too often," she said, "these children become outcasts in their society" because of the fear they too might be infected with HIV.

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