This study addresses one of the greatest challenges of our time: the damage caused by HIV and AIDS to the well-being of children and families. With 38.6 million people affected by HIV in 2006, with HIV prevalence at antenatal clinics exceeding 40 per cent in areas of Botswana and KwaZulu-Natal (South Africa), with nationwide adult prevalence in excess of the critical threshold of 20 per cent in several countries, and with the prospect of a rapid spread of the disease in large swathes of India, China and Russian Federation, the future of child well-being is seriously threatened. Certainly, in the 50 or so countries affected by the disease, the Millennium Development Goals in the field of child survival, education, poverty and basic rights will be missed, often by a large margin.