In 2001, 12 countries in Sub-Sahara Africa accounted for 70% of orphans. Ethiopia, Nigeria and the Democratic Republic of Congo (formerly Zaire) have the largest populations and also the largest number of orphans. By 2010 HIV/AIDS will play a significant role in increasing the number of orphans in these countries. In Nigeria the percentage of orphans due to AIDS will increase from 18% to 40%. In Ethiopia it will leap from 26% to more than 43%, and in the Congo it will increase from 34% to nearly 42%.

The impact of HIV/AIDS will be felt even more acutely in countries with smaller populations, but a higher incidence of HIV. In 2001, 10 of the nineteen Sub-Saharan African countries over 15% of children under 15 were missing mother, father, or both parents. For example, Zimbabwe has an orphan rate of 17.6% with more than three quarters due to AIDS. In Lesotho, Malawi, Swaziland, Botswana and Zambia at least 50% of orphans were due to AIDS.

The number of orphans will continue to rise for at least the next decade. By 2010, the number of orphans will represent at least 15% of all children in 12 sub-Saharan African countries. It projected that there will be 42 million orphans. Today's prevalence rated will to a large extent determine the patterns of orphaning for the next decade. In countries where HIV/AIDS prevalence has escalated, the full impact on the estimated number of orphans has yet to emerge.

Peter Puiot, Executive Director of UNAIDS
"HIV/AIDS has created an orphans' crises. This unprecedented crisis will require radically scaled up national, regional and community responses in the decades to come."

Carol Bellamy Executive Director of UNICEF
"We must respond to these devastating statistics by addressing the needs and rights of both the orphans and vulnerable children whose parents are still living. Countries that have high rates of orphaning due to AIDS also have high levels of children seriously impacted by the epidemic, such as those with ill parents or living in households that have taken orphans. They are often just as vulnerable."

Anne Peterson USAIDS Assistant Administrator for Global Health
"Responses need to be focused and scaled up in communities with high proportions of orphans affected by HIV/AIDS. And communities with emerging orphan issues need to prepare now for the upcoming challenges."

Children deprived of parents, families, teachers, homes, AIDS related discrimination, loss of inheritance and even the basic support needed to survive face a short life fill with hopelessness. Such extreme losses early in life seriously affect the children's overall growth and well-being. And, inevitably the health of society as a whole is also affected. They are at a higher risk for child labor, prostitution, illness and death. Even when extended families take in the over-whelming majority of orphan who lose both parents, in many cases, orphaned sibling are sent to different households and experience a second profound loss through this separation. Many foster families are poor and have to stretch their already inadequate resources to provide for both the orphans and their own children. In addition, some step or foster parents treat orphans harshly (Children on the Brink, 2002).

The increasing number of child headed households is indicative of the lack of the capacity and support system to care for these orphans. As traditional extended families cannot absorb all these children in need, millions of these children find themselves impoverished ill, on the streets and caring for others. They are also at risk for exploitation including physical and sexual abuse. Isolated from their families and other means of support they are forced into prostitution, risky sex behavior, and crime as a means of survival. While most orphans are born free of AIDS, their plight places them at increased risk for developing AIDS

One of the strongest indicators that orphaned children are suffering is their absence from school, and the education and sense of security it can provide. UNICEF recently reviewed the effect orphaning has on schooling and child labor in 20 sub- Saharan African countries. In all countries, children aged 5-14 who had lost one or both parent were less likely to be in school and more likely to be working more than a 40 hour a week. A survey of 646 orphaned and 1,239 non-orphaned children in Kenya found that 52% of orphaned children were not in school, while only 2% of non-orphaned children were not enrolled.

The ramifications of this unprecedented demographic event on the orphans, other disadvantaged children, families the economies in Sub-Saharan Africa is profound and in many cases immeasurable. The proportion of orphans is expected to remain unusually high at least through 2030. Long-term solutions need to be set in place to meet the needs of these children at risk.