FS in the context of severe HIV Epidemics: Key Issues and Challenges

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Food Security in the Context of Severe HIV
Epidemics Key Issues Challenges for Policy and
Programming
Daphne Topouzis A Policy Dialogue on Rural
Livelihoods Food Security in the Context of
HIV/AIDS in Southern and Eastern Africa CHGA
Interactive, Addis Ababa, 12 October 2004
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Food Security

• Food security exists when all people, at all
  times, have physical, social and economic access
  to sufficient, safe and nutritious food which
  meets their dietary and food preferences for an
  active and healthy life. WORLD FOOD SUMMIT,
  1996

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Dimensions of Food Security
Access
Availability
Stability
Source FAO, 2003
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Impacts of HIV/AIDS on Food Nutrition
Security
Labour, productive capital, agricultural
knowledge and skills, food aid dependency
HIV/AIDS
Food Availability

Labour, disposable income, assets, entitlements,
safety nets
HIV/AIDS
Food Access

Food availability and access over time capacity
to withstand shocks institutional viability
HIV/AIDS
Stability

HIV/AIDS
Nutritional knowledge, care, food preparation,
sanitation
Food Utilisation
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The relationship between food insecurity,
malnutrition AIDS
Source Save the Children/Oxfam
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Proportion of undernourished in total population
(1999-2001) and HIV adult prevalence estimates
(end-2003), Southern Africa
Sources FAO, State of Food Insecurity, 2003
UNAIDS 2004.
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Proportion of undernourished in total population
(1999-2001) and HIV adult prevalence estimates
(end-2003), East Africa
Sources FAO, State of Food Insecurity, 2003
UNAIDS 2004.
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Impact on rural/agricultural labour force under
review
FAO
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Challenges

• How can food security nutrition policy and
  programming
• prevent new HIV infections
• slow down the progression from HIV infection to
  AIDS-related illness
• support anti-retroviral therapy
• mitigate socio-economic impacts of AIDS

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Preventing new HIV infections

• Household food security can reduce vulnerability
  to HIV infection
• Implications for food security policy
  programming address underlying factors of
  vulnerability and resilience, using a gender lens

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Slowing down the progression from HIV to AIDS

• Adequate and nutritious food can slow down the
  progression from HIV to AIDS and improve the
  quality of life of PLWHAs
• Implications for FSN policy/programming
• Prioritise food nutrition counselling,
  care/support
• Consider the nutritional impact of low labour
  intensity crops
• Make FNS for PLWHAs an integral part of National
  FNS Strategies and National AIDS Strategies

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Supporting access to and management of ART

• ART a multi-sectoral issue
• Implications for FSN policy/programming
• Build partnerships with health sector in rural
  areas to strengthen access to primary health care
  and/or support NGOs that deliver ART.
• Raise awareness of the critical role of food and
  nutrition for those on ART.

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Mitigating AIDS impacts (1)

• Need for a long-term response perspective,
  combining relief, rehabilitation development
  initiatives
• e.g. food aid, access to land, rehabilitation of
  extension services, Junior Farmer Field Schools
• Need to strengthen the capacity of rural
  institutions, improve service delivery in spite
  of HIV/AIDS and protect HR

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Mitigating AIDS impacts (2)

• Need to base mitigation responses on evidence
  impacts of HIV/AIDS vary significantly depending
  on context
• e.g. the extent of the impact of HIV/AIDS on
  household labour varies
• emphasis on agricultural labour-saving
  technologies and food aid as mitigation
  strategies for affected households not
  appropriate in all contexts

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Challenges

• How to incorporate food security, nutrition,
  gender and HIV in national development
  instruments
• PRSPs
• Agriculture and rural development sector
  strategies
• National HIV/AIDS strategies

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Lifetime Risk of AIDS Death for 15-year-old Boys,
Assuming Unchanged or Halved Risk of Becoming
Infected with HIV, Selected Countries, 2000
Source Basia Zaba, 2000
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Food Security in the Context of Severe HIV
Epidemics Key Issues Challenges for Policy and
Programming
The End