The unseen outcome of nearly 20 million AIDS orphans without strong social service support is not just today’s humanitarian crisis—it is the socioeconomic catastrophe of the future.
Preventing unborn children from contracting their mother’s HIV/AIDS infection seems like the right thing to do. The programs are inexpensive, relatively easy to implement, last for only a few months, and usually provide a concrete, positive result—an infant free of infection. That is the intended or obvious result of the programs. The success of these programs is significant: Mother-to-child transmission (MTCT) of HIV falls from between 20 and 50 percent during pregnancy, delivery, and breastfeeding to under 5 percent. The unintended or invisible result of these programs is that over the last decade, they have swelled the ranks of AIDS orphans by allowing uninfected children to live long enough to watch one or both of their parents die from AIDS.
In 2009, UNAIDS estimated that there were more than 16 million children worldwide who had been orphaned because of the HIV/AIDS-related deaths of their parents. This figure was nearly equal to the population of Australia. The overwhelming numbers of these children live in sub-Saharan Africa, with Nigeria alone having 2.5 million AIDS orphans, South Africa having 1.9 million, Tanzania with 1.3 million, and Kenya and Uganda with 1.2 million AIDS orphans each.1
Looking more closely at the situation in South Africa, we see that the number of AIDS orphans as a percentage of total orphans has increased from virtually zero in 1990 to more than 75 percent today. Despite the laudable successes in adult HIV/AIDS treatment program coverage over the past several years, the Actuarial Society of South Africa estimates that this proportion will continue to grow to almost 82 percent by 2025.2
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