The HIV/AIDS -- Food Insecurity Nexus

Experts Meeting to Discuss Evidence, Effects, and Action

Cape Town—Policymakers, researchers, development experts and practitioners are gathering here from November 9-11 to discuss the critical links between HIV/AIDS, agriculture, hunger and malnutrition in Africa. Conference participants hope to enhance the understanding of these connections and bridge the divide between the HIV and food/nutrition communities. The ultimate goal is to identify opportunities to generate a truly multisectoral response to AIDS epidemics and ensure the food security of individuals and households facing their many effects.

The workshop is organized by the International Food Policy Research Institute (IFPRI) and partners in the Regional Network on AIDS, Livelihoods and Food Security (RENEWAL). Active in Kenya, Malawi, South Africa, Uganda, and Zambia for nearly a decade, RENEWAL aims to improve the lives of people in rural communities, where households are often dependent on agriculture for both income and food and the links between HIV/AIDS and hunger are particularly acute.

Based on 10 years of research in the region, discussions at the conference will include:

  • the effects of AIDS epidemics on agricultural extension and their interactions with climate change;
  • hunger and malnutrition as both drivers of HIV vulnerability and consequences of AIDS;
  • the impact of food price crises on individuals and households affected by HIV/AIDS; and
  • the critical importance of food and nutrition for people living with HIV.

“Agriculture is the backbone of most African economies and the main source of livelihood for people affected by HIV,” said Scott Drimie, IFPRI research fellow and RENEWAL coordinator. “Yet the AIDS epidemic in the region has seriously diminished the human capacity and financial resources of many agricultural extension departments, reducing farmers’ access to agricultural technologies and information that could improve their crop yields and income.”

According to RENEWAL research in Zambia, AIDS and other chronic illnesses accounted for close to 13 percent of staff deaths from 2002-2007, robbing extension agencies of their valuable workforce and reducing their effectiveness. For each agricultural worker who died during the prime of his career, the Zambian government lost an average of 12 years worth of investment in training. A study in Malawi shows a similar pattern: As rates of HIV increased within the agricultural extension system, so did staff vacancies. In turn, extension activities and outreach to farmers decreased significantly.

“As the capacity of extension agencies is eroded by the HIV/AIDS crisis, so is their ability to help farmers adapt to new challenges, including climate change, which threatens agricultural production and long-term food security,” added Drimie. “These links underscore the need to build bridges between the agriculture and health sectors to support rural households where AIDS and hunger not only coexist, but also often negatively reinforce each other.”

Years of research and experience confirm that HIV/AIDS and food insecurity are entwined in a vicious cycle. Food and nutrition insecurity heightens susceptibility to HIV exposure and infection, while AIDS in turn exacerbates hunger and malnutrition.

“This dangerous cycle is not only affected by chronic problems, such as the negative effects of climate change, but it is also aggravated by acute crises,” said Stuart Gillespie, IFPRI senior research fellow and RENEWAL director. “During times of economic hardship—whether brought on by high food prices, rising energy costs, or financial recession—people affected by the AIDS epidemic are among the most vulnerable, grappling with ‘crises within crises.’”

According to an assessment facilitated by RENEWAL in collaboration with partners in eastern and southern Africa, the 2007-2008 food price crisis hit people living with HIV and their communities particularly hard and constrained the ability of local and international organizations to assist them. Soaring food prices led more women to trade sex for money to pay for food, clothing, and other basic needs, as evidenced by numerous observations. Many HIV-positive individuals couldn’t afford the nutritious food they required, and as fuel costs rose along with food, many could not pay for transport to clinics and were thus unable to access antiretroviral drugs (ARVs). Other observations indicated that drug treatment was interrupted or not started, as patients realized they would not be able to meet the increased need for food the drugs would bring.

Research shows that if patients are malnourished when they start taking ARVs, they are six times more likely to die than individuals who are well-nourished when they begin treatment. Good nutrition is also necessary for the drugs to be effective and, without food, their side-effects can be severe. People living with HIV require up to 30 percent more energy than usual, in terms of calories and children may need 100 percent more energy. However, the onset of full-blown AIDS, and even death, can be delayed if HIV-positive individuals have a nutritious diet.

“Adequate food and good nutrition are crucial to slowly the progression of the disease and for the optimal nutrition and health of people living with HIV,” emphasized Suneetha Kadiyala, IFPRI research fellow. “Providing food assistance to HIV-affected individuals has tremendous potential to improve and extend their lives.”

A study conducted by RENEWAL and The AIDS Support Organization (TASO) in Uganda shows that when people living with HIV had sufficient food and a diverse diet, the severity of the disease was lessened, their nutritional well-being increased, and the quality of their life improved. The research in Uganda also confirms the importance of food aid. When HIV-positive individuals who were not taking ARVs received food assistance, progression of the disease was slightly delayed and they gained significant weight—an important predictor of survival—especially if they were suffering from an advanced stage of AIDS.

“The considerable connections between HIV/AIDS, food and nutrition security, and agriculture call for a multi-pronged approach to tackling the crisis,” concluded Dr. Gillespie. “By sharing concrete evidence on trends and effects, and the successes and failures in dealing with them, we hope to simultaneously make food and nutrition programs more HIV-sensitive, and strategies to address HIV more effective when it comes to nutrition.”

The International Food Policy Research Institute (IFPRI) seeks sustainable solutions for ending hunger and poverty. IFPRI is one of 15 centers supported by the Consultative Group on International Agricultural Research, an alliance of 64 governments, private foundations, and international and regional organizations.

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