April 2012

The effects of HIV/AIDS on people's livelihoods, food security, and nutrition are inextricably linked. While these links seem intuitive, the related issues fall into different areas of expertise. To bridge these differences and to improve how people work together, IFPRI launched the Regional Network on AIDS, Livelihoods, and Food Security (RENEWAL) in 2001. RENEWAL’s ultimate goal was to provide evidence-based research on these linkages in Sub-Saharan Africa in order to prevent or mitigate the impact and consequences of HIV/AIDS.

As a "network of networks" comprising national networks of organizations in the fields of food, nutrition, health, and HIV/AIDS, RENEWAL has helped strengthen network members’ skills in conducting research, publishing their results, and making them accessible to decision-makers. An important outcome was the publication of a series of more than 30 policy briefs that readers found critical to creating a common understanding of the two-way relationship between HIV/AIDS and livelihoods, nutrition, and food security. RENEWAL forged links among researchers, policymakers, civil society, and community-based groups by bringing them together in National Advisory Panels. These panels provided a unique opportunity for people to interact with other stakeholders and to discuss practical issues.

According to an independent impact assessment study on the influence of RENEWAL, the network’s activities have reinforced in all of the stakeholders’ minds how indispensable food and nutrition security are to developing a meaningful response to HIV/AIDS. Based on RENEWAL’s research:

• The Kenyan National AIDS Strategic Plan now includes food security and nutrition security as key components.
• The Ugandan AIDS Commission publicly credited RENEWAL with introducing food and nutrition into the country's National Strategic Plan.
• Several of Malawi’s strategic cross-sectoral plans covering HIV/AIDs used RENEWAL’s research.
• In Southern Africa, the Network of African People Living with HIV changed its programming for patients on Anti-retroviral treatment from cash transfers to indigenous food production.

On an international-level, RENEWAL was:

• Instrumental in helping to bring nutrition and food security issues into HIV/AIDS programming.
• A significant influence to the UNAIDS Program Coordinating Board’s agenda.
• Directly involved in the drafting of food and nutrition guidelines for the Global Fund to Fight AIDS, Tuberculosis and Malaria.
• Involved in drafting a nutrition strategy for the U.S. Presidential Emergency Plan for AIDS Relief (PEPFAR).
• Acknowledged by the World Health Organization for contributing to the integration of nutrition into a comprehensive response to HIV/AIDS.
• Played a role in the United Nations General Assembly Political Declaration on HIV/AIDS that recognized the goal "that all people at all times will have access to sufficient, safe and nutritious food… as part of a comprehensive response to HIV/AIDS."

As RENEWAL increased awareness and understanding of the links between food security and HIV/AIDS, and helped change the thinking within the conventionally separated communities of agriculture, nutrition, food security and HIV, it has had an impact on polices in many countries, as well as globally

• A number of countries have developed HIV/AIDS strategies where none existed before
• Agriculture and other sector policies in most target countries now include strategies that are relevant to HIV/AIDS
• Food and nutrition security interventions have been incorporated into several national HIV/AIDS strategies
• The United Nations has recognized food and nutrition security as an important part of the global response to HIV/AIDS.

The RENEWAL network-of-networks approach is considered by many stakeholders to be a model for responding to the interactions between HIV/AIDS and food security. For more information, see RENEWAL's website or the related Impact Assessment Discussion Paper.

Another on-the-ground impact of RENEWAL’s research showed that in spite of increased access to antiretroviral therapy in limited resource settings, the prevalence of food insecurity and undernutrition can compromise HIV care and treatment outcomes, including retention in care and adherence to treatment.

Based on this reality, many organizations providing HIV prevention, care and treatment services, including The AIDS Support Organization (TASO) in Uganda, have started integrating programs aimed to improve livelihood, food and nutrition security of people living with HIV, their households, and communities. The TASO-RENEWAL collaboration, initiated in 2006, strengthened the evidence that livelihood, food, and nutrition security interventions are a critical component of HIV care and treatment. The research showed that:

• Food security, especially diet quality, significantly lowered the odds of being underweight, being moderately anemic, and mortality among people living with HIV not yet eligible for antiretroviral therapy. Thus, the health and nutrition status of those who were not receiving antiretroviral therapy was less likely to deteriorate.
• Livelihood programs targeted to people living with HIV not only improved their perceived economic wellbeing and food security, but the participants of these programs also reported improvements in their sense of empowerment, pride, and independence.