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Countries experience


During the meeting representatives from governments, NGOs and donor agencies presented brief reports describing the strategies adopted and activities implemented to mitigate the impact of HIV/AIDS through the agricultural sector. The participating countries included: Cambodia, China, Ethiopia, Kenya, Malawi, South Africa, Tanzania, Uganda, Zambia and Zimbabwe. Countries reported that there are a few large-scale AIDS-related activities in the agricultural sector, yet, there was little evidence of an integrated agricultural sector strategy. Some of the examples presented did highlight possible entry points for the development of an agricultural sector response and guidelines for interventions.

Multisectoral response

Most participating countries have a national HIV/AIDS strategy led by the Ministry of Health. The agriculture ministries are still not sufficiently aware of the relationship between HIV/AIDS and food security and therefore, a major constraint to the development of an agricultural sector response was reported to be lack of awareness and political will. A coordinated response will require fundamental structural and budgetary reform in government institutions from vertical, sector-led structures to horizontal, team-led structures that are also able to integrate public-private partnerships and embark on a process of decentralisation. This is quite a challenge for most government institutions which tend to lack funds, resources and relevant experience.

Assessments of the impact of HIV/AIDS on the agricultural sector have been commissioned by the governments of Malawi and South Africa. Malawi also has an HIV/AIDS policy for agricultural extension and the government of Tanzania has incorporated HIV/AIDS-related concerns into the agricultural sector development strategy. In general, there was a strong feeling that agricultural sector mitigation strategies do not need to replicate the prevention and care activities of the health sector, but work with health interventions and integrate an effective response in order to meet the needs of those most affected by the epidemic more efficiently. However, countries recognized there is limited technical expertise on how to design effective agricultural responses to mitigate the impact of HIV/AIDS and to initiate effective mainstreaming activities.

Nutrition

The relationship between nutritional status, access and availability of food were clearly recognized by different countries. But the interaction between HIV/AIDS, nutrition and food security was not so clearly understood and in addition, the expertise for integrated nutrition and HIV/AIDS interventions were considered as health sector domains. Uganda had a programme on nutrition and HIV/AIDS, but in general, as yet, countries had not really addressed nutrition needs as part of an agricultural sector response to the HIV/AIDS epidemic.

Food security, nutrition and HIV/AIDS

In households coping with HIV/AIDS food consumption generally decreases. Research in Tanzania showed that per capita food consumption in the poorest households decreased by 15 percent when an adult died. A study carried out in Uganda showed that food insecurity and malnutrition were foremost among the immediate problems faced by female-headed AIDS-affected households. HIV exacerbates malnutrition, increases fatigue and decreases work productivity. Nutrition needs to be integral to all care and mitigation strategies. In drastic situations, food aid or feeding programmes might be inevitable for those most vulnerable and efforts still need to be made to improve the long-term food security.

Source: FAO (2002d)

Agricultural extension

Several countries reported to have HIV/AIDS mitigation programmes for extension workers in place. This is an obvious entry point for the agricultural sector and generally involves building the capacity of existing extension services to adapt to the new conditions posed by the disease. With appropriate training, extension workers can be encouraged to integrate HIV/AIDS considerations into their routine work and to facilitate community members in accessing appropriate resources. It was clear that extension workers should have a thorough knowledge of the disease and its impacts on food security and rural livelihoods, but that they do not need to become involved in the dissemination of health-related messages.

Countries also recognized that the capacity of agricultural extension organizations is being eroded with the continual staff attrition due to AIDS-related sickness and death. Loss of staff reduces the quality of the service, the geographical coverage and increases operational costs. Accessing rural communities was also highlighted by countries as a constraint to providing responsive services, with a recognition that agricultural sector activities need to move from district headquarters into more remote areas. But with the reduction in the number of extension workers and many HIV-afflicted households located in remote rural areas the situation appeared as an insurmountable challenge.

Policy environment

Many countries recognize the importance of creating an enabling policy environment in assisting in the mitigation of the HIV epidemic. Successful AIDS mitigation requires that policies are developed across sectors to support the multifaceted nature of rural livelihoods. For example, the legality of inheritance and property rights are integral to ensuring access to assets and household food security for women and their families, after her husband dies. In some countries, child protection and security measures are not sufficiently oriented towards the needs of AIDS orphans in their struggle to survive. On the other hand, South Africa provides a good example of cross-sectoral collaboration between the Agriculture and Land Affairs Ministries on a land redistribution programme. The Land Affairs Ministry also has developed an HIV/AIDS policy. However, in most countries government departments are organized in a vertical fashion and are often structurally separate from each other, making a multisectoral coordinated response difficult to initiate.

The multi-country HIV/AIDS programme for Africa

The World Bank has launched a Multi-Country HIV/AIDS Programme (MAP) for Africa, which aims to assist in the scaling-up of national HIV/AIDS efforts. The overall development objective of MAP is to increase access to HIV/AIDS prevention, care and treatment programmes, with an emphasis on vulnerable groups.

The programme for Ethiopia will finance the Government's 2000-2004 HIV/AIDS strategic plan that includes support for capacity building within both private and government agencies. Prevention, care and treatment activities will also be financed, to expand the public multisectoral response of civil society and communities to the AIDS epidemic. The Kenya programme will intensify the fight against AIDS, supporting five priority areas, that include prevention and advocacy, treatment and support of the continuum care of AIDS-affected people, management and coordination and mitigation of social impact, through research, monitoring and evaluation.

Source: World Bank (2001)

FAO/A. Proto

NGO initiatives

Non-governmental, community-based and women’s organizations, including those of persons living with AIDS, have developed a number of interesting responses to the HIV epidemic. Using participatory methodologies to identify key problem areas, some have established flexible, inter-sectoral activities to support women, orphans and the youth. Most of the activities described during the meeting consist of a wide range of integrated activities, from agriculture, skills training and micro-finance, to home care, support and counselling for those living with AIDS, which form part of a wider programme. A number of organizations are working actively to support people living with AIDS, to provide a support network to those living positively and assist in reducing stigma, collaborating with partners to improve the suitability of AIDS education information and to lobby for increased access to treatment in resource constrained environments.

The diversity of NGO activities demonstrates the necessity for a broad response to the impacts of HIV/AIDS which extends beyond a sectoral focus towards local, integrated rural development where community involvement and action are essential. These initiatives represent the forefront of the response to the epidemic and examples need to be found, in which NGO activities have been successfully integrated with those of a government or private sector agricultural partner.

Ugandan women's effort to save orphans (UWESO)

This national NGO was founded by a group of Ugandan women in 1986 and now totals about 10 000 women throughout the country. The organization began as a relief agency that distributed food and medicines in war-torn areas and gradually extended its activities to providing welfare assistance to needy orphans.

In Uganda, generally the heads of the foster families are overwhelmingly female - surviving widows, elderly grandmothers, often a female teenager, aunts or cousins - who themselves face serious labour constraints in terms of food production and farming, as well as inheritance problems and reduced purchasing power and creditworthiness – all of which reduce their food security, nutritional status and schooling.

In order to achieve the empowerment of these vulnerable groups, UWESO has implemented a project that provides training to foster families in skills such as micro-project management and business and provide access to microcredit for investment in income-generating activities. Complementary activities are also carried out such as training in food and nutrition security, and HIV/AIDS care and counselling. UWESO also provides out-of-school orphans with vocational training and apprenticeship opportunities, typically bicycle or radio repair, carpentry and tailoring. By combining capacity-building and microcredit provision, the project has enabled beneficiaries to engage in more secure and sustainable livelihoods, thereby increasing their household incomes significantly. This initiative has become a key example of how community resilience and coping mechanisms can be strengthened using technical training and microcredit as tools.

IFAD (2001b).

Table 3. Summary of case studies presented at the meeting

Country

Case studies

Entry points

Activities

Cambodia

Farmer life schools, Integrated pest management programme www.unaids.org/publications/documents/sectors/agriculture/Jc-fao-e.pdf

Rural farmers

Participatory action research

Analyse and develop local strategies for action

Promoting holistic development strategy

Lesotho

Maluti HIV and AIDS project Further information available from: mranneileng@yahoo.co.uk

Sick people Orphans

Income generation activities

Home-based care

Counselling

Orphan care

Tanzania

Mwanza urban livelihoods project

Further information available from: acordtz@africaonline.co.tz

Groups at high risk of HIV infection

People living with AIDS

Poor and vulnerable households, including those headed by women and children, orphans, widows

The wider community

HIV prevention through peer health educators

Promotion of gender equity

Environmental sanitation

Provision of micro-finance and business training

Tanzania

Low external inputs for sustainable agriculture (LEISA)

Further information available from: acordtz@africaonline.co.tz

Farmers

Vulnerable groups, especially orphans and widows

Local authority and organizational structures

Fishing camp residents and adolescents

Agricultural training in appropriate farming techniques

Loans for purchase of locally fabricated transport technologies

Loans for income- generating activities

Awareness-raising on HIV/AIDS

Uganda

Ugandan women’s effort to save orphans (UWESO) www.uweso.com/

Orphans

Guardians of orphans

Credit and loan schemes

Vocational training

Uganda

National community of women living with AIDS (NACWOLA)

Further information available from: AIDS Support Unit, Action Aid. Sempebwar@action aiduganda.org; nkangabwaj@ actionaiduganda.org

HIV positive women

Children of people living with AIDS

Communities of people living with AIDS

Counselling, home-care

Support for income generation

‘Memory project’

Awareness-raising

Uganda

People with AIDS development association(PADA)

Further information available from: AIDS Support Unit, Action Aid. ssempebwar@acti onaiduganda.org; nkangabwa j@actionaiduganda.org

People living with AIDS

Home care and support

Counselling

Income generation activities

Uganda

The AIDS service organization (TASO) www.taso.co.ug/

People living with AIDS

Food hygiene

Adequate and balanced diet

Local nutritious food

Uganda

Kitovu mobile farm schools

Further information available from: mmmuganda@utlonline.co.ug

Teenage school drop-outs

Agricultural and vocational training

Artisan apprenticeship

Uganda

African rural development initiative (ARDI) Further information available from: AIDS Support Unit, Action Aid. ssempebwar@ actionaiduganda.org; nkanga bwaj@actionaiduganda.org

Young mothers

People living with AIDS

Young people

‘Life skills’ education

Income support for young mothers

Counseling and home visits

Zimbabwe

Farmer field schools project

Marginalized farmers(principally widows and female heads of households)

Agriculture training and support

Training on healthy living with HIV/AIDS

Zimbabwe

African farmers’ organic research and training project (AfFOResT)

www.unaids.org/publications/documents/sectors/agriculture/Jc-fao-e.pdf

AIDS widows

Train farmer field workers

Trainers facilitate farmer field schools

Zambia

Household food security and nutrition www.unaids.org/publications/documents/sectors/agriculture/Jc-fao-e.pdf

Farm households

Increase food production

Improve access to nutritious foods

Decrease workloads with labour saving technologies

Raising awareness of nutritional needs of vulnerable groups

FAO/A. Proto


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