4. CREATING CAPACITY FOR AN MoA RESPONSE TO HIV/AIDS

This section summarizes the key issues raised in this paper and proposes policy and operational adjustments to address the adverse effects of the epidemic on MoAs and their work. The recommendations presented below are intended not only for MoAs but also for their partners (donors, NGOs, the private sector, etc.). Given the spatial and temporal pattern of the HIV epidemic, recommendations cannot be generic, but need to be based on country and sector level assessments of capacity and response needed.

More importantly, these recommendations can only translate into action after overall capacity erosion within MoAs is assessed and addressed. Given that day-to-day survival is the over-riding concern for most people in sub-Saharan Africa, long-term policies on HIV/AIDS are often of little relevance to MoA staff and clients alike. Therefore a key issue, which is however beyond the scope of this paper, is the need to strengthen overall MoA capacity. In other words, it is not only capacity erosion resulting from HIV/AIDS that needs to be addressed, but overall capacity erosion in MoAs. Otherwise, responses to the epidemic are likely to be hampered. This renders concrete recommendations problematic, for how can remedial measures to HIV/AIDS impact be adopted in a context of extensive MoA capacity erosion?

Four areas of HIV/AIDS relevance to MoAs have been addressed in this paper: a) MoA staff vulnerability to HIV infection and AIDS impact; b) the disruption of MoA operations and erosion of capacity; c) the increased vulnerability of MoA clients to food and livelihood insecurity; and d) the continued pertinence of certain MoA policies, strategies and programmes in view of the conditions created by the epidemic.

Creating capacity for an MoA response to HIV/AIDS requires a two-pronged approach: a) addressing the impact of HIV/AIDS within the Ministry; and b) adjusting agricultural policies, programmes and operations to the adverse effects of the HIV epidemic.

4.1 Addressing the impact of HIV/AIDS within MoAs

HIV/AIDS directly affects MoA staff and their families through morbidity and mortality. Yet, even in countries with high adult HIV/AIDS prevalence rates, staff knowledge and awareness of HIV/AIDS may be inadequate and perceived self-risk of HIV infection may be low. HIV/AIDS stigmatisation and discrimination in the workplace are present in varying degrees. In addition, certain categories of MoA staff are particularly vulnerable to HIV infection. These include employees who need to travel extensively in order to carry out their duties, such as agricultural extension workers, high level professionals who frequently attend seminars, conferences and in-service training as well as drivers. These groups often have to spend extended periods away from their homes and families.

HIV/AIDS-related morbidity and mortality disrupts MoA operations and undermines MoA capacity by:

a) reducing staff productivity (through loss in human resources, absenteeism due to morbidity and funeral attendance, etc.);

b) increasing ministerial expenditures (due to costs related to HIV/AIDS absenteeism, medical and burial costs, recruitment and replacement costs, terminal benefits, etc.);

c) increasing staff turnover;

d) augmenting the workload of MoA staff; and by

e) depleting MoA knowledge, skills and experience.

MoA response measures to these impacts have largely focused on human capacity development (sensitisation and training) and on HIV/AIDS mainstreaming. Capacity building efforts to date have largely been limited to health-based, IEC initiatives. In the future, capacity development should encompass the technical aspects of AIDS impact and focus on strengthening the analytical capability of agricultural planners to incorporate the socio-economic impacts of the epidemic into their policies, strategies and programmes.

The following recommendations may assist MoA and their partners to address the adverse effects of HIV/AIDS on MoAs:

1. Assess epidemic impact on MoA operations, policies and programmes. Depending on the severity of the impact of HIV/AIDS, this may necessitate one or more of the following activities:

a) Gather qualitative and quantitative data on the direct/indirect costs (medical, burial, administrative, and other costs) of the epidemic on MoAs, including staff absenteeism, turnover, etc. for planning purposes. A useful tool with which to quantify the costs of the epidemic may be the AIDS Impact Calculator, designed by the South African company "Lifeworks". This tool, which could be adjusted for MoA use, can determine likely increases in costs of recruitment and training, death, illness and disability benefits.^[95] Another useful tool is the HIV/AIDS Toolkit Template for Government Sectors developed by Abt Associates Inc., and the Health Economics and HIV/AIDS Research Division of the University of Natal in South Africa which has a module specifically on "HIV/AIDS and the Department of Agriculture." This tool can help MoAs undertake internal and external HIV/AIDS impact assessments.

b) Identify key administrative, managerial and technical MoA posts currently vacant which need to be urgently filled in order to prevent disruption of essential services.

c) Gather qualitative and quantitative data on the impact of HIV/AIDS on MoA target groups through Participatory Rural Appraisal (PRA), on farming systems (through farming systems vulnerability mapping overlaid with HIV/AIDS prevalence rates and impact levels) and on food and livelihood security (through livelihood systems vulnerability mapping that can capture HIV/AIDS impact).^[96] Closely monitor changes in the nutritional status of MoA target groups.

2. Establish AIDS in the workplace programmes

AIDS in the workplace programmes can help MoAs address the vulnerability of their employees to HIV infection and AIDS impact (in terms of access to information on HIV/AIDS, safe working conditions, the relevance of workplace benefits and human resource procedures; and the technical capacity of staff to deal with HIV/AIDS concerns in their work). In particular, such programmes should:

a) institutionalise IEC prevention, care and support initiatives and ensure that awareness-building campaigns in particular target both professional and support staff and are conducted on a regular basis;

b) create a supportive working environment by eliminating HIV/AIDS stigma and discouraging discrimination of MoA staff living with HIV/AIDS: as long as stigmatisation and discrimination are present, it is unlikely that an enabling environment can be put in place to address vulnerability of MoA staff to HIV infection and AIDS impact. There is a need for policies and procedures that: break down HIV/AIDS stigma; promote acceptance and support of project staff living with HIV/AIDS; and protect the rights of MoA staff living with HIV/AIDS. These should include provisions for care and support for MoA staff living with HIV/AIDS and their families.

c) review and modify working conditions of employees exposed to high risk situations which render them vulnerable to HIV infection (i.e. align duty station and home bases so that MoA staff does not work in one area and live in another; limit the number of overnight stays required of MoA staff on duty travel, etc.) A concerted effort should be made not to stigmatise these employees by singling them out but to address the conditions which expose them to an increased risk of HIV infection; and

d) help staff members and their families cope with AIDS impact and plan for the future through counseling, legal advice, loans, etc.

e) capacity-building and training in the technical aspects of the impact of HIV/AIDS. It is often assumed that MoA professional staff are capable of addressing the adverse effects of the epidemic on their work. Yet, MoA professionals may not have the capacity or know-how to respond to the technical implications of HIV/AIDS in their area of expertise (e.g., the implications of labour shortages for agricultural research and extension, etc.). This will require staff training on the impact of HIV/AIDS on rural households and on the linkages between HIV/AIDS and the core technical areas of MoA work and on the implications for programme implementation and/or service delivery (e. g. how to assist households to sustain their productive capacity in spite of labour shortages, asset depletion, and the increased demand for food and income);

f) appoint an HIV/AIDS Focal Point within the MoA to help incorporate HIV/AIDS concerns in the core work of the Ministry. This Focal Point should have concise and agreed upon Terms of Reference which should be familiar to all MoA staff; and

g) continuous advocacy to elicit political commitment for HIV/AIDS at the highest level of the ministry.

As seen from the above, HIV/AIDS workplace programmes need to be defined more broadly than they have been to date to encompass more than IEC HIV prevention initiatives and programmes. The choice of appropriate interventions will vary considerably from country to country. The list of interventions above is meant to provide a broad framework on the basis of which individual MoAs can design HIV/AIDS workplace programmes tailored to their needs.

3. Review and adjust MoA human resource policies and procedures to reflect the changes in the institutional and rural environments brought about by HIV/AIDS.

In many countries in sub-Saharan Africa, human resource policies and procedures are not the prerogative of MoAs but of other institutions. In the case of Uganda, for instance, human resource policies are the responsibility of the Public Service Commission (PSC). The effects of young adult morbidity and mortality hasten the urgency for closer cooperation between human resource institutions and line Ministries within a multi-sectoral framework so that uniform solutions can be found for all Ministries. Mechanisms are needed to facilitate networking and negotiation between these institutions, in order to expedite human resource policy reforms and procedural adjustments. UNAIDS can play a leading role in putting such mechanisms into operation.

Human resource areas that need to be prioritized include the following:

• mitigating skill, managerial and professional losses;

• planning for alternative social security options, such as a health care scheme (the medical allowance agreement negotiated in Zambia between the MAFF and the unions is one example) and a welfare fund to assist staff members with HIV/AIDS and their families;

• introducing multi-skilling at all levels and adjustments in training strategies;

• reviewing and adjusting current administrative procedures, such as terms for sick leave, unofficial leave, emergency advances, etc.

4. Increase flexibility in operational modalities

Operational adjustments may be needed to minimize disruption of MoA services, such as postponement of training or field day exercises organized by the Ministry due to funerals, caring for sick people, etc. "We, in [agricultural] extension", reports the MAWRD in Namibia, "will have [to have] flexible programmes to accommodate cancellations at short notice, and then reschedule activities also at short notice."^[97]

5. Adjust MoA budgets

Unless HIV/AIDS is introduced in MoA budgets, it is unlikely that a concerted effort can be made to address the direct and indirect costs of the epidemic on MoA staff and the need for response measures. One of the lessons learned from HIV/AIDS mainstreaming exercises is that despite the valuable work undertaken during the project phase, much of it is lost once the project ends not only because of lack of funding but also because HIV/AIDS has not been incorporated in MoA budgets and workplans.

6. Build ownership and follow-up into HIV/AIDS MoA initiatives

Ownership of HIV/AIDS impact assessments, of capacity development initiatives and of other response measures is essential but often lacking. For example, it has been shown that MoAs are usually not actively involved in the design and conduct of research on the impact of AIDS on agriculture and on rural communities. Their lack of active participation has meant that the findings of the studies conducted, regardless of their quality, are either not shared with MoAs or not utilized by them. This explains in part why agricultural policies and programmes often do not take HIV/AIDS into account.

Follow-up to HIV/AIDS impact assessments and to pilot initiatives is another critical area of concern. In spite of a number of quality studies on the impact of HIV on agricultural production systems, rural livelihoods and household/community coping mechanisms, concrete follow-up initiatives in these areas remain scarce. Yet, if a multi-sectoral approach to AIDS is to succeed, follow-up activities should be given at least as much emphasis (in terms of resources and technical input) as the research or pilot activity itself. In other words, there is a need for more emphasis on programming so that HIV/AIDS impact assessments become part of on-going MoA programmes.

4.2 Adjusting MoA policies, programmes and services

HIV/AIDS can undermine smallholder agriculture and food, nutrition and livelihood security through: a) a decline in agricultural production and land and labour productivity; b) an increase in expenditures and a decline in on- and off-farm disposable income; c) the erosion of household resources and of the asset base; and d) an erosion of the knowledge base and skills needed for agricultural production.

Through these and other effects, HIV/AIDS-induced young adult morbidity and mortality are changing some of the assumptions upon which agricultural policies, strategies and programmes are being designed. In particular, labour constraints, high dependency ratios within farm households, the growing number of households headed by the elderly, youth and women and the likely decline in the quality of the labour force (as more children are taken out of school to care for sick relatives) are among the factors that need to be considered when reviewing the continued relevance of agricultural policies and programmes.

The content of farm support services may also need to be reviewed to ensure that various forms of labour substitution, credit and technical assistance are made available to vulnerable households. The development and adoption of appropriate technologies to reduce the time women spend on water and fuel collection, for instance, can be instrumental in releasing labour for agricultural or regular caring tasks. Applied research on income-generating opportunities for rural men and women as alternatives to agriculture (especially for those who are no longer able to farm) is also important.^[98]

Given the magnitude of the impact of HIV/AIDS, it has been argued that a paradigm shift may be necessary for agricultural research and extension services in order to put sharp focus on: household food and nutrition security, poverty reduction, and the rehabilitation of the environment.^[99] This will require a gender-balanced, participatory approach and a focus on low-risk, low-input strategies for smallholder agriculture to ensure that the felt needs and interests of smallholder farm households, and particularly female-headed households and households headed by the elderly and orphans, are met.

The mandate of agricultural extension services may also need to be broadened to encompass HIV/AIDS concerns. A promising methodology for target group HIV prevention and AIDS mitigation has been developed by the Global Integrated Pest Management Facility (IPM) in Asia (Box 13). The FAO Community IPM Programme in Cambodia has extended the Farmer Field School (FFS) learning process to HIV/AIDS. Farmer Field Schools use the Agro Eco-system Analysis to analyse crop cycles and their vulnerability to pests. Farmer Life Schools (FLS) use the Human Eco-system Analysis to identify supporting and non-supporting factors as they relate to household and community economy, health, education, social relations, culture and the environment. HIV/AIDS is one of the topics covered.^[100] The FLS approach seeks to raise awareness among farmers through a dynamic learning process rather than a top-down teaching exercise. Farmers learn how to analyse their problems rather than being taught what their problems are. This empowers rural men and women and could prove instrumental to behaviour change. Similarly, IPM's training methodology focuses on training trainers in facilitation skills and problem solving analysis rather than on fixed messages delivered to the farmers. Valuable lessons on using agricultural extension services to impart messages on HIV prevention and AIDS mitigation learned from the IPM FFSs can be extended to sub-Saharan Africa.

The following initiatives may help MoAs and their partners adjust agricultural policies, programmes and services to the conditions created by HIV/AIDS:

1. Adopt an HIV/AIDS mandate

Adjustments of agricultural policies, strategies and programmes are likely to be conditional to the adoption of an HIV/AIDS mandate endorsed at the highest political level that specifies which effects of HIV/AIDS fall within the mandate of the MoA and how the epidemic affects these (i.e. the promotion of labour-intensive export crops, etc.). Such a mandate needs to be accompanied by awareness-raising within and beyond the MoA to sensitize staff, partners and clients to the significance and implications of this mandate.

2. Address rural producer needs and circumstances

In the pursuit of increased food production, the producers and the conditions in which they live and work can be overlooked. Given that HIV/AIDS not only affects agricultural production but also household food and nutrition security and livelihood systems, it is not enough to know which farming systems are vulnerable to labour loss. It is also important to identify those households and producers who are most vulnerable to food and nutrition insecurity, to prioritize their needs and to explore through which structures the goods and services they require for survival can be delivered.^[101]

This will entail taking account of the changes in the composition of MoA clientele brought about by HIV/AIDS (namely, the growing number of elderly, women and children assuming tasks previously performed by young adult men) in its policies and programmes. However, it should be emphasised that HIV/AIDS does not create a "new clientele" as has sometimes been argued. Households headed by the elderly, widows and youths (as a result of disease, war and drought) have always been part of the clientele of MoAs. HIV/AIDS has increased the proportion of these groups, which now make up a growing proportion of MoA clienteles.

Addressing rural producer needs and circumstances will also entail taking account of the changing nutritional needs of households and communities affected by HIV/AIDS directly or indirectly.

In order to address the felt needs, interests and constraints of rural producers, a shift is needed from a production- to a client-based approach. The objective should be to bolster the resilience of farm households by helping them cope with shocks and crises, including HIV/AIDS, and by enhancing household food, nutrition and livelihood security.

3. Address HIV/AIDS as a contributing factor to food, nutrition and livelihood insecurity

There is a need to incorporate HIV/AIDS as a contributing factor to food, nutrition and livelihood insecurity alongside other shocks that befall rural households, such as drought. What is of critical importance to MoAs is that unlike other shocks, HIV/AIDS can be, in some instances, one from which vulnerable households may never recover.^[102] The adverse effects of AIDS on the farm household production-domestic labour interface in particular, need to be understood as a central component of HIV/AIDS-induced food and livelihood insecurity. Further, the implications of HIV/AIDS on the nutritional status of household members, and particularly children, also need to be addressed.

4. Factor labour constraints in the formulation of smallholder agricultural policies and programmes

Smallholder agricultural policies may, in some cases, need to take into account the growing labour constraints associated with HIV/AIDS and the ensuing potential disruption to the rural economy and social structure. In many countries in sub-Saharan Africa, agricultural policies tend to be premised on intensive food production strategies on the basis of virtually unlimited labour availability. Such assumptions may need to be revisited in view of the scale of the HIV epidemic.

For example, the banana/coffee/bean farming system in a Tanzanian village in Bukoba District has changed into a cassava/sweet potato farming system under the impact of HIV/AIDS.^[103] Major changes in livestock management have also been recorded. One study concludes that agricultural strategies for Bukoba District need to reflect these changes. At present, research and extension strategies in the district are geared toward the maintenance and promotion of the banana/coffee system.^[104] This is premised on the assumption that household farm labour is readily available. Yet, as argued above, this may no longer be the case in areas heavily affected by the HIV epidemic.

Further, the implications of changes in farming systems on nutrition also need to be addressed as there are may be shifts toward less nutritional crops which could have far-reaching implications for household nutrition security.

5. Factor household coping mechanisms to HIV/AIDS in the formulation of smallholder agricultural policy and research

To give but one example, cassava and sweet potatoes are considered "orphan crops" in mainstream agricultural research programmes in Tanzania. One study recommends that the two crops-which are increasingly being re-introduced into farming systems as a result of the impact of AIDS - be upgraded from "hunger crops" to "main subsistence crops," thus providing them with their required share of research and development attention. In other words, resources must be allocated for research and extension on these tuber crops to enhance food security in vulnerable households.^[105] By extension, policy recommendations about the relative merits of particular crops in a given farming system should take into account the impact of HIV/AIDS on household labour and income. Research should correspond more closely to the needs of farm households with high dependency ratios and of households headed by the elderly, women or the young.^[106] Equally importantly, there is a need to ensure that crops being promoted are not only less labour intensive but, equally importantly, of high nutritional value.

6. Promote low-risk, low-input strategies for female-headed households, and for households headed by the elderly and by youths and orphans. These may include:

• The reclamation of traditional food crops (cassava, sweet potato, cowpea, sorghum, finger and pearl millet), in addition to open-pollinated maize varieties with a lower input requirement, and improved storage qualities.

• Inter-cropping of cereals and cucurbits to fix nitrogen and smother weeds.

• Creation of community seed banks to facilitate the conservation of traditional genetic resources.

• Enhancement of soil fertility and elimination of the need for ploughing through the planting of live fences to protect mulched and zero-tilled fields.

• Live fences to provide fodder, fruit, oil and a refuge for the natural enemies of many crop pests.

• Improved availability and planting of fruit trees to supplement local diets and provide an opportunity to gain additional income, with only limited extra labour.

• The reduction of the labour requirement and risk associated with the keeping of cattle, by encouraging farmers to raise small livestock (chicken and rabbits) as a protein source as well as for manure.

• Zero-grazed dairy cows to eliminate the need for herding and produce bio-gas for household use.

• Cash crops which require low inputs to reduce production costs (this would need to be accompanied by natural methods of soil amelioration and pest management).^[107]

7. Protect land ownership rights, particularly among women and children.

Issues related to land ownership are of critical importance to households affected by HIV/AIDS. In Siaya and Kisumu Districts of Kenya, for example, land has been demarcated for issuance of title deeds but only 58% of households have title deeds for the land they own. The rest do not legally own the land they farm, have not collected their deeds, or are uncertain of the status of the land they believe they own.^[108] One study recently found that under the pressure for cash created by AIDS morbidity, many families lose their property without their knowledge, while an increasing number of women and their sons are taking male heads of households to court for having sold the only land the family owned in order to raise money for medication.^[109] Protecting the rights of women and children in terms of land ownership needs to be prioritized, given that without land these families may be unable to sustain themselves.

8. Mainstream HIV/AIDS in MoA policies, programmes and operations

Experience with mainstreaming HIV/AIDS concerns to date reveals that: a) projects should be supported for longer than one year and should preferably be located within "hard" MoA units (such as crop production, extension, livestock, etc.) rather than in "soft" units; b) there should be adequate resources for follow-up activities; and c) ownership is a critical factor for the sustainability of mainstreaming efforts. The following measures may assist MoA in mainstreaming HIV/AIDS:

i) Incorporate HIV/AIDS in MoA workplans and policy/programme documents

This is necessary in order for mainstreaming exercises to be sustainable, and to ensure that HIV/AIDS is integral to policy and programme design and implementation.

ii) Integrate HIV/AIDS in donor-supported MoA initiatives

Every MoA has a number of donor-supported projects and programmes operating in headquarters and in various parts of the country. In Zambia, for instance, the MAFF has a total of 10 donor-funded programmes.^[110] Only one, the UNDP-supported Smallholder Farming Systems Diversification Programme had an HIV/AIDS component in 1999, but it appears that this was almost exclusively health-oriented. If MoAs are to be encouraged to address HIV/AIDS in their core programmes, donor-supported projects must also follow suit or else HIV/AIDS activities will continue to be conducted on an ad hoc basis.

iii) Incorporate HIV/AIDS in the curriculum of agricultural colleges and training institutions

To ensure that future recruits of MoAs and partner organizations have the requisite skills with which to address the technical implications of the impact of HIV/AIDS on their work, the MoAI in Malawi has recommended that HIV/AIDS is included in the curriculum of the Natural Resources College (a training institution for Field Assistants and Farm Home Assistants, among others).^[111] The FAO Representative in Namibia has even suggested introducing agricultural education in the curricula of primary and secondary schools.^[112]

iv) Introduce HIV/AIDS in Agricultural Sector Networks

More than 20 years into the HIV epidemic, a number of sub-Saharan African countries have gained a great deal of knowledge and experience in addressing the impact of HIV on agriculture and rural development. However, the knowledge and experience gained are under-utilized, as networking and sharing of experiences among the various countries in the region are largely absent or else limited. To some extent, MoAs have been responding to the epidemic in relative isolation. A few ministries have initiated similar types of activities, such as the production of IEC materials on the impact of the epidemic on agricultural extension workers. This duplication of effort is in many cases unnecessary and it depletes the meager resources available for HIV/AIDS initiatives.

Many MoAs have drawn up plans of action to address HIV/AIDS. For example, the MoAaC of Tanzania endeavours to:

• integrate HIV/AIDS into agricultural research;

• integrate HIV/AIDS control interventions into the agricultural extension system;

• create a data bank to provide information on various aspects of the epidemic; and

• strengthen the analytical capability of planners to enable them to project the socio-economic impacts of the epidemic on rural households, communities and the nation.^[113]

The main constraint for the MoAaC is that it does not have the resources to implement its plan of action. This is likely to be the case in many other countries. Thus, even if an MoA has a comprehensive plan of action for HIV/AIDS, this may not be sufficient, as financial resources and technical competence may be lacking.

One way to overcome this relative isolation of efforts and the lack of resources is to explore the various networks serving the agricultural sector and identify a suitable one for the exchange of experiences, data and best practices on agriculture-specific responses to HIV/AIDS. The objective would be to use each Ministry's comparative advantage in the response to the HIV epidemic and to assess the replicability of successful initiatives, identify common needs, develop training capabilities within a common framework and share training materials. For instance, one MoA may have focused on addressing the impact of AIDS on agricultural extension services while another may have focused on the impact on livestock production. Some MoAs may have focused on training methodologies while others may have focused on human resource issues.

A first step towards incorporating HIV/AIDS into existing agricultural sector networks would be to draw up an inventory of potential areas of response to HIV/AIDS that each Ministry of Agriculture can undertake on the basis of its comparative advantage. Next, activities to be undertaken within the network will have to be prioritized, after which the modalities of how to operationalize and coordinate the proposed interventions and address the issue of resources would need to be defined.

A key task would also be to get the impact of HIV/AIDS on agriculture as a sector more clearly defined and measured. This will help redefine key policy issues and generate effective ways of responding to the impact of the epidemic on agriculture and rural communities. UNAIDS can play an important role in this process by making its website available to MoAs in order to facilitate the dissemination and distribution of research documents, HIV/AIDS impact studies and other relevant documentation.

The Consultative Group on International Agricultural Research (CGIAR) or one of its affiliates (such as the International Service for National Agricultural Research or ISNAR) could be one such network through which the impact of HIV/AIDS on the agricultural sector in general and on MoAs in particular could be addressed. The CGIAR's system-wide initiative on the impact of HIV/AIDS on agriculture, agricultural research and development (SWIHA) provides an appropriate platform and entry point for such an exercise.

Another such network could be the Southern Africa Development Community (SADC) Food Security Network currently being coordinated in Harare, Zimbabwe, which could be supported to facilitate the dissemination of HIV/AIDS information and best practices in MoAs and to act as a repository of information for member countries.