The Situation

This section looks at the current HIV/AIDS situation, in general, and its effects on children and young people, in particular. It looks at the scale of the epidemic, its likely trends and some of its impacts. For more detail, see also the situation affecting children, their families and communities and the countries and regions in which they live. Key points about the global situation regarding orphans and other vulnerable children are:

1. The number of children who have been orphaned has risen dramatically as a result of HIV/AIDS.

2. More than 90% of children orphaned by AIDS live in Africa.

3. Even if no-one else is infected with HIV from today, the number of orphans and children made vulnerable by AIDS will remain high for many years.

4. Many children who have not been orphaned are vulnerable as a result of HIV/AIDS. For example, this includes children whose parents are sick and those who live in poor families which have taken in children orphaned by AIDS.

Numbers of people affected

This huge epidemic is having devastating impacts at different levels:

Children themselves experience direct impacts. For example, some children are infected with HIV themselves. UNAIDS estimated in 2003 that there were approximately 2.5 million children, under the age of 15, living with HIV worldwide. Most children orphaned by HIV/AIDS are not HIV positive. Many HIV-positive children are not orphans. Children also experience psychosocial effects of parental illness and death and frequently face stigma and discrimination . Girls may face particular problems. Orphans and other children affected by HIV/AIDS find themselves vulnerable to exploitation, abuse and to contracting the virus themselves. Despite this, many children and young people are extremely resilient and are able to cope even under extreme circumstances.

Families and communities are affected by HIV/AIDS. Household income may fall as a result of parental illness and death. Livelihoods may be lost. Children and young people are expected to assume "adult" roles. They have less time and money to get health, education and social welfare services. Communities have to care for more sick people, orphans and other vulnerable children. This means that traditional community ?safety nets? and social support systems become strained.

Countries and regions are experiencing the impacts of HIV/AIDS. In severely affected countries, life expectancy is declining. Improvements in infant and under-five mortality have been reversed. There are increasing levels of sickness. This affects health services, employment and a country's economy in general.

Understanding the numbers

Many of the documents in this section contain numbers about HIV/AIDS and orphans and other vulnerable children. These can help to understand the situation in a particular country or area. However, they can sometimes be difficult to understand. Reasons for this include:

1. The numbers are so large. This is particularly true when considering the situation in the world as a whole.

2. The numbers are usually estimates. It is important to try to understand how these estimates have been made and how accurate and reliable they are likely to be.

3. The situation may be measured in different ways. Common measures include:

Prevalence - the number of people living with HIV/AIDS at any one time. This is made up of all the people who have been infected with HIV apart from those who have already died. In 2003, UNAIDS estimated that there were 34-46 million people living with HIV/AIDS in the world. Prevalence in the world is usually stated as the total number of people living with HIV/AIDS. This may also be done for countries. However, this makes comparisons between different countries difficult because total populations can be very different. As a result, prevalence of HIV/AIDS in different countries is often expressed as the percentage of people living with HIV/AIDS (compared to the total population). It is important to know whether these percentages include both adults and children, or refer to adults only.
Incidence - the number of new people infected with HIV/AIDS in a year. For example, in 2003 UNAIDS estimated that 4.2-5.8 million people were infected with HIV around the world.
Various effects of HIV/AIDS , including the number of people dying of HIV/AIDS. This is particularly important when considering children orphaned by HIV/AIDS. For example, in 2003 UNAIDS estimated that 2.5-3.5 million people died of AIDS around the world.

4. Definitions and terms used to describe different situations vary. This applies particularly to estimates of numbers of orphans and other vulnerable children . When looking at numbers relating to orphans and other vulnerable children, it is helpful to ask the following questions:

Does the number include paternal orphans ?
What was the upper age limit used for the children?
Is this the total number of children who have been orphaned over time (cumulative) or is it the number of current orphans? The number of current orphans will be lower because some will have become adults and some will have died.
What countries or geographical areas are included or have been left out of the calculations?

Resources

The State of the World's Children 2006 (Eng)

This report highlights the millions of children who have not been the beneficiaries of past gains, the ones who are excluded or 'invisible'.
UNICEF, 2006, PDF, 156pages

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Children: The missing face of AIDS: A call to action (Eng)

This document highlights the priorities of the global campaign on children and AIDS - 'Unite for children, Unite against AIDS'.
UNICEF, UNAIDS. 2005, PDF, 2260kb, 14 pages

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Pediatric HIV/AIDS Fact Sheet (Eng)

This is a brief, up-to-date summary of key statistics relating to the HIV epidemic internationally and in the US.
Elizabeth Glaser Pediatric AIDS Foundation, 2003, PDF, 4 pages; 108 kb.

Children on the Brink: Strategies to Support Children Isolated by HIV/AIDS (Eng)

This major and key publication about work with children affected by HIV/AIDS contains statistics on children orphaned by HIV/AIDS from 88 countries, analysis of the trends found in those statistics, and strategies and principles for helping the children.
Hunter, S. and Williamson, J., UNAIDS, UNICEF and USAID, 2004, PDF, 46 pages, 6.3 mb.

Children on the Brink: Strategies to Support Children Isolated by HIV/AIDS (Fre)

Children on the Brink: Strategies to Support Children Isolated by HIV/AIDS (Spa)

Into the 21st Century: Designing Care and Protection Programs for Children Affected by HIV/AIDS (Eng)

This is part of a longer PowerPoint presentation which supports work done by UNICEF on national programme assessments.
Hunter, S., UNICEF, PowerPoint, 19 pages, 1813 kb.

A Framework for the Protection, Care and Support of Orphans and Vulnerable Children Living in a World with HIV/AIDS (Eng)

This framework is based on lessons learned over many years. It considers families and communities as the foundation of an effective, scaled-up response.
UNICEF, 2004, PDF, 23 pages, 397 kb.

Policies for Orphans and Vulnerable Children: A Framework for Moving Ahead (Eng)

This clear and concise document focuses on recommending an 'OVC policy package' which can be used by nations seeking to respond positively to problems being faced by orphans and vulnerable children.
Smart, R., POLICY Project, 2003, PDF, 36 pages, 1056 kb.

AIDS, Public Policy and Child Wellbeing: Chapter 1: Overview of the Impact and Best Practice Responses in Favour of Children in a World Affected by AIDS (Eng)

This document is the first chapter of a major publication which provides a detailed overview of issues relating to the impacts of HIV/AIDS on children.
Cornia, G.A., UNICEF, 2002, PDF, 33 pages, 267 kb.

The White Oak Report: Building International Support for Children Affected by AIDS (Eng)

This document reviews the scale of the AIDS epidemic, its psychosocial effects on children and its impact on families and communities.
Levine, C. and Foster, G., The Orphans Project, 2000, PDF, 6 pages, 140 kb.

AIDS, Public Policy and Child Wellbeing: Chapter 10: The HIV/AIDS Impact on the Rural and Urban Economy (Eng)

This document is the tenth chapter of a major publication and looks at the impact of HIV on the economy, including a focus on GDP and particular economic sectors.
Cornia, G.A. and Zagonari, F., UNICEF, 2002, PDF, 37 pages, 301 kb.

AIDS Epidemic Update (Eng)

The annual AIDS epidemic update reports on the latest developments in the global HIV/AIDS epidemic.
WHO/UNAIDS, 2004, PDF, 94 pages, 7008 kb.

Le Point sur l'Épidémie de SIDA (Fr)

The annual AIDS epidemic update reports on the latest developments in the global HIV/AIDS epidemic. (French version)
WHO/UNAIDS, 2004, PDF, 95 pages, 6784 kb.

Resumen Mundial de la Epidemia de VIH/SIDA (Sp)

The annual AIDS epidemic update reports on the latest developments in the global HIV/AIDS epidemic. (Spanish version)
WHO/UNAIDS, 2004, PDF, 96 pages, 7301 kb.

AIDS Epidemic Update (Rus)

The annual AIDS epidemic update reports on the latest developments in the global HIV/AIDS epidemic. (Russian version)
WHO/UNAIDS, 2004, PDF, 95 pages, 5829 kb.

The AIDS Emergency: The Toll on Women and Children (Eng)

This paper, written by the Ugandan Minister of Gender, Labour and Social Development, argues that HIV/AIDS remains a significant problem globally despite advances made on treatment.
Mukwaya, J., 1999, PDF, 16 pages, 217 kb.

Enumerating Children Orphaned by HIV/AIDS: Counting a Human Cost (Eng)

This article is a critique of official estimates and projections for the number of children orphaned by HIV/AIDS, such as that provided by 'Children on the Brink'.
Monk, N., Association Francois-Xavier Bagnoud, 2002, PDF, 21 pages, 255 kb.

AIDS, Public Policy and Child Wellbeing: Chapter 15: The Impact of HIV/AIDS on Orphans and Programme and Policy Responses (Eng)

This document forms chapter 15 of the book entitled 'AIDS, Public Policy and Child Wellbeing'. It identifies five key policy challenges faced as the result of the increased number of orphans and vulnerable children as a result of HIV/AIDS.
Phiri, S. and Webb, D., 2002, PDF, 43 pages, 137 kb.

AIDS, Public Policy and Child Wellbeing: Introduction (Eng)

This document is the introduction of a major publication which gives an overview of the issues relating to the impact of HIV/AIDS on children.
Cornia, G.A., UNICEF, 2002, PDF, 2 pages, 56 kb.

AIDS, Public Policy and Child Wellbeing: Contents (Eng)

This document is the contents page of a a major publication which provides a detailed overview of issues relating to the impact of HIV/AIDS on children.
Cornia, G.A., UNICEF, 2002, PDF, 2 pages, 101 kb.

AIDS, Public Policy and Child Wellbeing (Eng)

This is a major publication with more than 15 chapters which looks at the various impacts of HIV/AIDS on child well-being globally.
Cornia, G.A., UNICEF, 2002.

Watching our Language (Eng)

This document is a compilation of comments made on the CABA and OVC taskforce listservs following a posting by John Williamson in which he expressed concern about the stigmatising effect of using any acronym (e.g. OVC, CABA) to apply to another human being.
Various, CABA/OVC Taskforce listservs, 2003, PDF, 6 pages, 118 kb.

Guidelines for Sampling Orphans and other Vulnerable Children: Summary (Eng)

This is a detailed guide to how to conduct a survey of orphans and vulnerable children in a developing country. It is available as a detailed manual and this summary.
Turner, A.G., UNICEF, 2003, PDF, 7 pages, 120 kb.

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Guidelines for Sampling Orphans and other Vulnerable Children: Full Manual (Eng)

This is a detailed guide to how to conduct a survey of orphans and vulnerable children in a developing country. It is available as this detailed manual and a summary.
Turner, A.G., UNICEF, 2003, PDF, 42 pages, 280 kb.

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West and Central Africa Regional Workshop on Orphans and Other Vulnerable Children Workshop Report; Yamoussoukro, Cote d'Ivoire; 8-12 April 2002 (Eng)

This is the workshop report of the West and Central Africa Regional Workshop on Orphans and Other Vulnerable Children, which was held in Yamoussoukro, Cote d'Ivoire from 8-12 April 2002.
UNICEF, UNAIDS, USAID, FHI, International Save the Children Alliance, 2002, PDF, 59 pages, 479 kb.

Africa's Orphaned Generations (Eng)

This report by UNICEF illustrates the situation of orphans and other vulnerable children in sub-Saharan Africa.
UNICEF, 2003, PDF, 52 pages, 763 kb.