Some experts predict even more dramatic increases are to come. The impact on children extends beyond those infected, as millions in the hardest-hit countries suffer the loss of parents and caregivers, and thus incur much greater risks to their health, nutrition and education. Such a decline can have a significant impact on a child's development. A fall in literacy rates in many countries is expected since children in AIDS-stricken households are taken out of school when families can no longer afford fees or when children are needed to help out at home or to earn an income.
Orphans living in extended families are also generally the first to be denied an education.
AIDS is also decimating the ranks of the skilled and educated during their prime years, with potentially tragic implications for future development. In some African countries hit hard by AIDS, it is no longer unusual to see children under 15 heading households. The burden is also great on already inadequate health care systems. In most developing countries, the disease is increasing the price of health care and reducing its availability, which will have the greatest impact on the poor. In many communities, healthy children whose parents have died from AIDS are at greater risk of dying of preventable diseases, because their illnesses tend to be attributed to AIDS and thus to go untreated.