A grim spectre of more than 30 million orphaned children in developing countries emerges when the AIDS epidemic is projected forward to the end of the decade, the US aid agency, USAID, told the international conference on AIDS yesterday.
The aid agency, one of the leading US organisations charting the parameters of the virus, calculated that AIDS, and secondary illnesses which prey on its emaciated victims, would leave 30.3 million orphaned children under the age of 15 by 2010 in the 34 sub-Saharan, Asian, Latin-American and Caribbean countries.
The exponential implications of AIDS come into sharper focus when placed against the number of orphans left in the past 15 years. The USAID figure is more than double that for 1985-2000, and markedly higher than the 20 million orphans projected by Unicef.
But that difference is partly accounted for by the different definitions of orphan applied by the two organisations. USAID defines an orphan as a child who has lost either parent, whereas Unicef, like UNAIDS, describes an orphan as a child whose mother or both parents have died.
A USAID report, Children on the Brink, presented to the conference in Durban yesterday, described the scale on which children are being orphaned by AIDS as unprecedented in world history, in large measure because AIDS, unlike war and earlier epidemics, seemed to be a longer-term problem.
The report concurred with earlier analyses presented to the conference of the geographical spread of AIDS: it is worst in sub-Saharan Africa, where the President of the most powerful country in the region, President Thabo Mbeki of South Africa, has labelled the figures cited by international aid organisations as "hysterical".
But in neighbouring Swaziland - which is nearly enveloped by South Africa - parliamentarians were yesterday preparing to debate a resolution calling for legislation to make sterilisation of AIDS-infected adults compulsory. The man behind the resolution, Mr Sikakadza Matsebula, said the need for sterilisation was urgent.
An official of Swaziland's Health Ministry, however, spoke against the resolution, arguing that sterilisation would not halt the scourge of AIDS.
Nearly one in four Swazi adults is estimated to be infected with HIV, a higher rate than the UNAIDS figure for South Africa but not as high as that for neighbouring Botswana.
Coincidentally, in his address to the Senate hearing on foreign operations in Africa, the US ambassador to the UN, Mr Richard Holbrooke, labelled the fight against AIDS the "toughest and biggest" problem facing the world. "Of all the issues that we face in the world today, if you ask what is the number one problem . . . I would say AIDS." While AIDS is concentrated in Africa, it is a world problem rather than an African problem, Mr Holbrooke continued. He approved a pending Security Council resolution urging member nations to encourage all soldiers, but particularly those serving on UN peacekeeping missions, to undergo voluntary and anonymous HIV tests. "It is a huge step forward," he said.
The international AIDS conference ends today with a closing address by the former South African president, Mr Nelson Mandela. He has previously defended the approach to AIDS taken by his successor, President Mbeki, observing that Mr Mbeki is a man who thinks deeply about the problems facing him and his country.
Maggie Fox reports from Durban:
African scientists, fearful of being exploited by drug firms and researchers from richer nations, said yesterday they were joining forces to make sure any AIDS vaccine that is developed benefits Africans.
Experts told the Durban conference that unless the entire structure of how vaccines are developed and sold is changed, it will be 15 years before any vaccine "trickles down" from rich nations to developing countries.
Topics discussed on the fringes of the conference included ways for poor countries to import generic versions of anti-retroviral drugs from countries such as Brazil and India without breaking international patent law, UN officials said yesterday
Researchers told the conference that the first vaccine approved to work against a strain of HIV found specifically in Africa would be tested on British volunteers later this year.
Trials of a vaccine begin in South Africa in January, and South African scientists said they were starting work on their own vaccine.