HIV/AIDS is having devastating consequences on families, young children, and other vulnerable social groups. In this paper, I review the impact of HIV/AIDS on families and development in sub-Saharan Africa. I begin by showing the magnitude of the problem and the factors that have led to rapid spread of HIV/AIDS in this sub-continent. I discuss gender inequality, poverty, social inequality, and globalization, and show how these facilitate the rapid spread of the epidemic. I show how AIDS is creating a mass of orphans on the one hand, and how it is impacting development and creating new public health contradictions on the other. By orphans I mean all those children who have lost either a mother or father or both parents due to AIDS. I argue that AIDS is destroying families and communities and is also manufacturing a great number of orphaned children who are powerless and vulnerable. In order to solve this problem, I suggest the adoption of appropriate, pragmatic, and realistic short- and long-term strategies of dealing with the problem. I conclude by suggesting that the long-term strategy aimed at reducing the number of orphaned children will involve the adoption of appropriate strategies that seek to control HIV/AIDS once and for all.