This report outlines the context and current situation of children orphaned by HIV/AIDS in Africa, examines the impact of orphaning on families, communities, and on the orphans themselves, and describes a framework for priority actions that includes community mobilisation, sharing of information, and raising awareness of the issues on a regional and global scale.

The report also recommends interventions that would encompass more than the material needs of families caring for orphans. "Psychosocial support is an essential, but often overlooked, service ... early intervention is vital."

It concludes with an outline of the responses needed from African governments and the international community to alter the course of the crisis. Nevertheless, it pointed out, the family remained the "single most important factor in building a protective environment" for children orphaned by HIV/AIDS.

From the Executive Summary:

"Among the most devastating effects of the HIV/AIDS epidemic in sub-Saharan Africa is that it is orphaning generations of children - jeopardizing their rights and well-being, as well as compromising the overall development prospects of their countries.

• In 1990, fewer than 1 million sub-Saharan African children under the age of 15 had lost one or both parents to HIV/AIDS.
• At the end of 2001, 11 million in this age group were orphans because of HIV/AIDS, nearly 80 percent of the world total.
• By 2010, 20 million in this age group are likely to be orphans from this single cause, comprising about half the total number of orphans expected in the region.

"The core of a framework of action, developed by a number of international agencies, including UNICEF [United Nations Children's Fund], UNAIDS [The Joint United Nations Programme on HIV/AIDS], and USAID [the United States Agency for International Development], highlights the need for strong action on five fronts.

1. Strengthening the capacity of families to protect and care for orphans and other children made vulnerable by HIV/AIDS. In sub-Saharan Africa,extended family relationships are the first and most vital source of support for households affected by HIV/AIDS, including for orphaned children.
2. Mobilizing and strengthening community-based responses. After families, communities provide the next level of support.
3. Ensuring access to essential services for orphans and vulnerable children. Orphans and other vulnerable children need a number of services to ensure their rights and well-being, including education, birth registration, health care and nutrition, psychosocial support, safe water and sanitation, and strong and independent justice systems.
4. Ensuring that governments protect the most vulnerable children. While the family has primary responsibility for the care and protection of children, national governments have ultimate responsibility for guaranteeing the rights of children.
5. Raising awareness to create a supportive environment for children affected by HIV/AIDS. Action against HIV/AIDS has to be a shared national responsibility."

Letter from Mark Connolly, UNICEF, to The Communication Initiative November 26 2003; IRIN Plus News, November 26 2003; and the UNICEF website accessed on June 5 2009.