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Orphaning in sub-Saharan Africa
Friends from Botswana

The rapid spread of HIV/AIDS throughout Sub-Saharan Africa has created a generation of orphaned children. In total, there were 43 million orphans, from all causes, in sub-Saharan Africa in 2003. In little over a decade, the number of children orphaned by AIDS increased from less than 1 million to more than 12 million.1

As the percentage of orphans rises, children are at risk of declining welfare given household limitations and the strain placed on public systems. The impact of orphanhood or having a sick caregiver varies by region, socio-economic status of the household, and other factors, but there is growing evidence that orphaned and vulnerable children face health and educational disparities and emotional distress. They may be more mobile, moving more often than non-orphaned children. They may also be at a higher risk of sexual exploitation, using sex to earn an income, and of engaging in high-risk sex for comfort and support.
 
Children at Dula Sentle

The escalating orphan crisis is trailing the 32 million AIDS deaths that have occurred globally since the pandemic began.1 The sheer number of orphans is higher in Asia (80.1 million) than in sub-Saharan Africa (SSA), (43.4 million), yet the situation is disastrous in SSA, where the number of children orphaned by AIDS increased from 3 million in 1995 to more than 12.3 million by 2003. In SSA, 12.3% of all children are orphaned, while nearly one in five children are orphaned in Botswana, Swaziland and Lesotho (Figure 1).2 SSA is now home to 64% of the world’s HIV infected people, 64% of the world’s new HIV infections in 2004, and 80% of the world’s children orphaned by AIDS.1 The situation is worsening in eleven Southern African nations.

Adults aged 20-44, or those in their prime childbearing and rearing years, carry the greatest burden of disease, thus fueling the orphan crisis. In 2003, HIV prevalence among adults aged 15-49 was 7% across SSA1, yet the rate climbed to 23% across the 10 worst affected nations clustered in southern Africa, so that on average, nearly one in four adults are infected. Swaziland (38.8%), Botswana (37.3%), and Lesotho (28.9%) have the highest HIV prevalence rates.1 Moreover, while there is evidence that incidence rates are declining in East Africa, there were 3.1 million new infections in 2004 throughout SSA, up from an estimated 2.9 million in 2002.1

Twelve percent of orphans are aged 0-5, 33% are aged 6-11, and 55% are aged 12-17.1 Without parental care, orphans aged 0-5 are at risk of higher mortality, while orphans aged 6-17 are at heightened risk of psychological trauma, educational disparities, and economic and sexual exploitation.3-6

References

1. UNAIDS, WHO. AIDS Epidemic Update: December 2005. Geneva: UNAIDS, WHO; 2005.

2. UNICEF, UNAIDS, USAID: Children on the Brink 2004: A Joint Report of New Orphan Estimates and a Framework for Action.  New York, 2004.

3. Sarker M, Neckermann C, Muller O: Assessing the health status of young AIDS and other orphans in Kampala, Uganda. Tropical Medicine and International Health 2005; 10(3): 210-215.

4. Monasch R, Boerma J: Orphanhood and childcare patterns in sub-Saharan Africa: an analysis of national surveys from 40 countries. AIDS 2004; 18(Suppl 2): S55-65.

5. Ainsworth M, Filmer D: Poverty, AIDS and children's schooling: A targeting dilemma. World Bank Policy Research Working Paper 2885: World Bank, 2002.

6. Atwine B, Cantor-Graaea E, Bajunirweb F: Psychological distress among AIDS orphans in rural Uganda. Social Science & Medicine 2005; 61: 555–564.

 

Why use the phrase "orphan epidemic"?

Because the number of children orphaned by AIDS is growing nearly exponentially in sub-Saharan Africa. It isn't clear how many children are "vulnerable" because their parent or guardian is living with AIDS or other diseases.
UNICEF, UNAIDS, USAID 2003