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You are an elderly woman living on a meager sustenance, on the outskirts of a town called Vijayawada. Your name is Durgamma. Your home is a tiny two-room concrete block, approximately 200 square feet, in a slum known as the Vambay Colony.

You share this small home with your nine and twelve year-old grandsons. You never expected to be raising and providing for children again at this age, but your grandchildren are living with you because their parents died of AIDS first their father, who brought the infection home, in 2001; then their mother your daughter followed in 2004. There was no one left to take care of the young brothers except you.

Soon you learn that your youngest grandson is HIV-positive. He begins to grow ill. He battles many infections. He cries in the night when he's sick and calls for his mother.

Almost crippled with severe joint pain, you can barely walk and cannot physically work; even if you could, someone has to care for the sick boy. There is no one to provide an income for this new family that has formed. So your oldest grandson must go to work. He leaves home for weeks at a time to travel for migrant construction or agricultural jobs, paid 30 to 50 rupees per day on a good day.

You know this twelve-year-old child should be in school. Both of your grandchildren should have better childhoods than this, but they have been traded in far too soon for adult work and worries, for hardships that no children should ever have to face. But what can you do? There is no one else. There is no other way.

This is your new normal.

In India, nearly two million children have lost their parents to AIDS, making it the country with the most AIDS orphans in the world; and their numbers are expected to double within five years. Like sub-Saharan Africa in the last decade, India is on the cusp of a burgeoning AIDS pandemic one that will disproportionately affect its children. The disease is silently spreading and reaching critical proportions. The sheer size of India's population more than one billion makes a widespread AIDS pandemic almost unimaginable.

These statistics are shocking to most of us in the United States, where widely available anti-retroviral therapy has slowed the progression of HIV and contributed to a dramatic decline in mortality. It's easy to forget that every single day, almost three times as many people die of AIDS in developing countries as died in the World Trade Center on 9/11. A common misperception of the western world is that the

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