South Africa has the most Aids orphans in the world, according to a United Nations Children's Fund (Unicef) report released this week.
The report focused on data from 2005. It found that a total of 15.2 million children around the world had lost at least one parent to Aids. Most of these children were in sub-Saharan Africa – and 1.2 million were in SA.
These are not the only South African orphans.
Unicef estimated that a massive 2.5 million South African children under 18 had lost at least one parent due to any cause, with about 450 000 having lost both parents.
For those countries with data, only seven had more children who had lost both parents - China, Democratic Republic of Congo, Ethiopia, India, Nigeria, Uganda and Zimbabwe.
Unicef said orphans often lost out on schooling, food and clothing, they may suffer anxiety, depression and abuse, and they had a higher risk of exposure to HIV.
Aids effects kids in many ways
"Orphans due to Aids are not the only children affected by the epidemic.
"Many more children live with parents who are chronically ill, live in households that have taken in orphans due to Aids or have lost teachers and other adult members of the community to Aids."
Access to meds still lacking
Unicef estimates that about 240 000 South African children under 15 were HIV-positive, a figure matched globally only by Nigeria. About 28% of these needed antiretroviral (ARV) treatment but only 18% of those who needed it were getting it.
About one third of an estimated 250 000 HIV-infected pregnant mothers received ARVs. About a third received ARVs for prevention of mother-to-child transmission, which Unicef said showed progress as this had increased from 22% the year before.
Only about 64 000 of the babies born to HIV-infected mothers - about a quarter of them - started cotrimoxazole prophylaxis, to prevent opportunistic infections that can be fatal.
Unicef said the virus progressed rapidly in children, with about a third dying before their first birthday and about half before their second. Last year about 380 000 children died around the world from Aids-related causes.
Most deaths preventable
"The vast majority of these deaths were preventable, either through treating opportunistic infections with antibiotics or through antiretroviral treatment."
The World Health Organization recommends giving cotrimoxazole to HIV-positive children and to babies born to HIV-positive mothers.
Unicef said South Africa was one of a few countries which had been able to scale up HIV treatment of children by integrating this into sites for adults.
ARVs for children now cost about 60 US dollars a year (about R430).
Unicef estimated that 5% of South African boys aged 15 to 24 years and 15% of the girls that age were HIV-positive.
About 18% of the country's adults were estimated to be HIV-positive.
Grants do help
Unicef said that child grants help.
"In South Africa, for example, the country with the largest number of orphans due to Aids, more than 7.1 million children under 14 living in poverty - 79% of those eligible – were benefiting from the child support grant by April 2006.
"This represents a two-thirds increase since 2004 and a 20-fold increase since 2000.
"More than 325 000 children were benefiting from foster care grants in 2006." – (Sapa)