Every year over a quarter of a million children die of AIDS. Another two million children currently live with HIV, most in sub-Saharan Africa. Millions more are affected when AIDS enters their families or their communities. Orphans are perhaps the most visible: 15 million children have lost one or both parents to AIDS; 12 million of them live in sub-Saharan Africa.

The increasing burden of care due to HIV/AIDS falls mainly on extended family: first they care for the sick and dying relatives, and then they take responsibility for the children left behind. Today, the extended family cares for over 90% of double orphans. Adults who take on these immense caregiving burdens have less time for their own children, fewer financial resources, and greater difficulties securing food and shelter. Thus, children who have parents providing care to sick relatives or who share scarce resources with foster children may also experience disadvantage. In communities severely affected by AIDS, traditional safety nets are often eroded by cumulative mortality: teachers are absent from school because of their own illness or that of family members, and basic health facilities can be overwhelmed by AIDS care needs, all of which leave children increasingly vulnerable. The impact is most severe in environments where government- and state-level support is weakest-where universal education, health care, and social welfare are either partially available or not available at all.

Protecting Childhood in the AIDS Pandemic will bring together lessons from experts around the world on what has worked, and what would need to be done to transform the outcomes of children of all ages whose lives have been affected by HIV/AIDS. Examining which public policies and programs have worked best to meet the full range of children's needs, from medical care to social support and from infancy to adolescence, this is the volume for academics, social scientists, policymakers, and on-the-ground practitioners.

Jody Heymann is founding director of the McGill Institute for Health and Social Policy, and founding director for the Project on Global Working Families, Harvard.

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