11 November 2010
To ensure food security for a rapidly growing global population, governments are investing heavily in agriculture. But food policy experts say that investment must include HIV/AIDS prevention and treatment.
HIV/AIDS and food have been inextricably linked from the time the pandemic began sweeping across the continent.
The disease struck the ranks of farmers hard, leaving the livelihoods of millions of people in jeopardy. Before treatments were available, those infected with HIV knew that starvation would kill them quicker than the virus. So, they demanded health workers give them food before agreeing to learn about safe sex. Today, even for those receiving anti-retroviral treatment, food is essential to make that therapy effective.
For food security to be achieved in the coming years, experts say HIV/AIDS must be part of the plan. That was the reason for a meeting this week in Cape Town, South Africa, where experts discussed a decade of work on HIV and nutrition security.
HIV, food and farms
Stuart Gillespie is director of RENEWAL, the Regional Network on AIDS, Livelihoods and Food Security, with hubs in southern African countries.
He says, "Originally, we looked at the ways in which HIV/AIDS may exacerbate food insecurity by the stress it places on the household, particularly the most productive household members. And we have documented ways in which through labor shortages, through diversion of labor within the households, it affected the ability of households to actually engage in agriculture. And agriculture itself is still the number one source of livelihood for most people affected by HIV on the planet."
The effects of the pandemic on farmers can still be seen today. Gillespie says it helped to create haves and have-nots.
"In some ways, HIV has made certain farmers actually richer. They've been better able to buy off land from people who are desperate to sell because they're in a situation of distress and they're starting to sell off assets possibly due to AIDS, possibly due to AIDS plus other factors, like the food crisis. So you see the interconnections," he says.
HIV/AIDS also affected agricultural extension services, which provide farmers with support and technical expertise.
Gillespie says, "During a five-year period between 2002 and 2007 in both Malawi and Zambia, one in eight agricultural extension workers had actually died of HIV during that period. And the quality of extension that was available due to these staff shortages, which were not made up, declined, significantly. People weren't able to do their jobs properly in agricultural extension. Farmers were therefore not able to avail themselves to new technologies."
High prices, food shortages
When the food crisis struck a few years ago, Gillespie says it had a detrimental effect on HIV/AIDS programs in Africa.
"We had documented it two years ago during the last food price hikes that these kind of dramatic rises in prices can significantly impact prevention issues, prevention strategies with HIV. They can impact treatment, the ability of people to remain on drugs when they're too hungry, when they cannot afford to buy food to meet the increased appetite they have [when] on the drugs. And it will also affect mitigation because households are grappling with other financial and economic problems, as well as HIV," he says.
He says people will stop taking anti-retroviral drugs if they can't get enough to eat. Food is necessary to help counter the side effects of the drugs.
"They need 30 percent extra calories alone on treatment."
Gillespie is also a senior research fellow with IFPRI, the International Food Policy Research Institute in Washington. He says without food security, the progress made against HIV/AIDS may be lost.
"If people are stopping drugs because they are too hungry to take the drugs without feeling completely sick – if they're stopping the drugs and compliance levels drop below 90 percent – we're in a situation where the virus becomes resistant to the drugs. And therefore, we need second line therapies or third line therapies, which are going to be a lot more expensive and even more difficult to resource in the current climate of austerity," he says.
Food experts and HIV/AIDS organizations are joining forces to find ways of better integrating food security policies with HIV/AIDS prevention and treatment. That includes helping ensure the health of African farmers.