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AIDS orphans and vulnerable children (OVC): Problems, responses, and issues for Congress

Tiaji Salaam (Analyst in Foreign Affairs)

Congressional Research Service (CRS)

11 February 2005

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Since HIV/AIDS was discovered in 1981, more than 20 million people have lost their lives to the virus. According to the Joint United Nations Program on HIV/AIDS (UNAIDS), nearly 40 million are currently living with HIV/AIDS, including nearly 2.2 million children under the age of 15. In 2004, 4.9 million people acquired the virus, and 3.1 million died from AIDS. Sub-Saharan Africa remains the most affected region with 25.4 million people living with HIV/AIDS at the end of 2004, 1.9 million of whom were children under the age of 15. The United States Agency for International Development (USAID), the United Nations Children’s Fund (UNICEF), and UNAIDS estimate that at the end of 2003, 15 million children under the age of 18 had lost one or both parents to AIDS, with the majority (82%) in sub-Saharan Africa. In just two years, from 2001 to 2003, the global number of children orphaned by AIDS increased from 11.5 million to 15 million. By 2010, it is expected that more than 25 million children will be orphaned by this deadly virus. Due to the 10-year time lag between HIV infection and death, officials predict that orphan populations will continue to rise for a similar period, even after the HIV rate begins to decline. Experts say only massive spending to prolong the lives of parents could be expected to change this trend.

The impact of HIV/AIDS on children is just beginning to be explored. Not only are children orphaned by AIDS affected by the virus, but those who live in homes that have taken in orphans, children with little education and resources, and those living in areas with high HIV rates are also impacted. Children who have been orphaned by AIDS may be forced to leave school, engage in labor or prostitution, suffer from depression and anger, or engage in high-risk behavior that makes them vulnerable to contracting HIV. Children who live in homes that take in orphans may see a decline in the quantity and quality of food, education, love, nurturing, and may be stigmatized. Impoverished children living in households with one or more ill parent are also affected, as health care increasingly absorbs household funds, which frequently leads to the depletion of savings and other resources reserved for education, food, and other purposes.

Congress passed P.L. 108-25 (“The United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003") in the 108th session, which authorizes 10% of HIV/AIDS funds to be used for children orphaned or made vulnerable by the virus. A number of other pieces of legislation were introduced to support this population, though none made it to full conference. It is expected that related legislation will be introduced in the 109th session. Some of the issues that the drafts are expected to address include streamlining U.S. global HIV/AIDS initiatives, establishing a senior coordinating position for children orphaned by HIV/AIDS, and expanding aid to children orphaned from other causes. This report explores some of the challenges facing children affected by HIV/AIDS and governments with large populations of those children, reviews U.S. and international efforts to address the needs of children affected by HIV/AIDS, and outlines some key issues that may be considered by Congress in the 109th session. This report will be updated.

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