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The impact of HIV/AIDS on agriculture and food security

The evolution of the epidemic

A hypothetical pattern of an epidemic over time can be represented with a highly stylized s-shaped or logistic curve (figure 1). In the initial stages of the epidemic, the HIV prevalence is quite low and is followed by a period of acceleration (stage I to stage II) where the virus is spreading at a rapid rate throughout the population. This stage of acceleration is followed by a period of slowing growth where the numbers of new infections stabilize, but a high proportion of the population at risk already has been infected (stage III). Eventually both new infections and the proportion of infected should decrease.

The HIV epidemic is particularly devastating as people do not leave the HIV infected population by getting better, but by dying. Consequently, the epidemic curve that represents HIV infection can be followed by a similar curve a number of years later which represents the accumulation of those who died from AIDS-related causes.

The pattern of the epidemic varies between regions and within countries; the epidemic may level off in some countries at modest levels, while in others, sizeable proportions may be infected before an upper limit is reached. In southern Africa, for example, HIV rates are still rising, with HIV infection among more than 40 percent of all pregnant women in some locations. In West Africa, the apparent stability of the epidemic has turned out to be a misconception, with the prevalence rates now taking off again (UNAIDS 2002). In spite of variations in epidemic patterns, it is important for the agricultural sector to recognize that countries and regions can be at different stages of the epidemic and may need different response strategies.

Figure 1. Stages of the epidemic

Source: Barnett, T. (2001)

Rural poverty, mobility and vulnerability

It is estimated that 42 million people in the world are infected with the HIV virus and 95 percent live in developing countries (UNAIDS 2002). Assuming that each HIV/AIDS case directly influences the lives of four other individuals, at least 160 million people are likely to be affected by the epidemic (Barnett, Whiteside 2002). With more than two-thirds of the population of the 25 most affected African countries living in rural areas and largely dependent upon agriculture as a means of subsistence, any HIV/AIDS mitigation strategy has to encompass the livelihoods of rural agricultural populations (FAO 2002a).

Rural farming systems are comprised of a diverse range of tasks which generate both farm and off-farm income. Households are becoming increasingly dependent upon off-farm sources, in particular cash income or remittances from migrant labour, whether to buy farm inputs or pay school fees. These structural forces forge dynamic links between rural and urban areas, increasing their interdependence and serving as a channel for the flow of cash, people and as a route for all infectious disease, including the transmission of HIV.

HIV/AIDS and mobility
Mobile people are those who move from one place to another temporarily, seasonally or permanently for a host of voluntary or involuntary reasons. They include truck drivers, seafarers, transport workers, agricultural workers, business people, traders, employees of large industries, miners, government officials, uniformed service officers, construction workers and sex workers.

Internal migrants move within their country of birth and include rural-urban movements and resettlement, whereas external migrants cross country borders. While being mobile itself is not a risk factor for HIV, the situations encountered and the behaviours adopted during the mobility process may increase a person’s vulnerability to the disease, for example:

  • Mobile people and migrants may be marginalized, subject to discrimination, exploitation and harassment. They may have little social or legal protection and little participation in the host community.

  • Poverty and lack of resources may force those moving from one place to another to trade unprotected sex for goods, services and cash in order to survive.

  • Mobile people have little access to HIV/AIDS education, health services or means of preventions such as condoms and sexually transmitted infection treatment services. Lack of access may be a result of cultural and linguistic barriers, unfamiliarity with the area and undocumented status.

  • Factors such as loneliness, separation from regular partners, variations in disposable incomes, peer pressure, recreational options and freedom from social norms may encourage people to take risks which make them vulnerable to HIV.

People are also affected by mobility through interaction with others who are mobile even if they are not mobile themselves and so become vulnerable to the risk of HIV transmission. They include spouses, children and the elderly.

Source: UNDP (2001)

Poverty and mobility are critical dimensions of vulnerability to HIV transmission. The driving force behind migratory movements is poverty, in addition to the lack of livelihood opportunities in rural areas. Migrant workers who are away from home for extended periods of time are more likely to engage in casual, unprotected sex, thus increasing their risk of exposure to HIV transmission.

The agricultural sector plays an important role in influencing migratory patterns. Many commercial estates employ large numbers of seasonal migrant workers. The accommodation that is provided on commercial estates tends not to support the families of workers, are often over-crowded, lack privacy and provide situations that are conducive to casual and commercial sex. In addition, small farmers who are involved in cash crop production often have to travel to complete marketing arrangements and buy new inputs. Infrastructure projects facilitate agricultural production and marketing but also encourage high levels of labour mobility and temporary migration.

Those less mobile groups who remain in rural areas have to manage the impacts of the HIV epidemic with a dwindling resource base. Those without land, or with marginalized land and fragile farming systems are far less able to cope with the impacts of HIV/AIDS, and as an increasing number of sick HIV-infected urban dwellers return to their rural communities, survival strategies become stretched and food security threatened. Rural populations are at a further disadvantage as they have little access to appropriate information and health services and so are less able to equip themselves with the knowledge to prevent the risks of transmission.

The major impacts of HIV/AIDS on food security and rural livelihoods are summarized in table 2 and some of the most important are outlined in the following paragraphs.

Loss of productive generations

Demographic projections of the impact of HIV/AIDS on population structures reveal dramatic changes in the size, age and sex compositions (figure 2). Not only will the total population be reduced, but the projected age and sex structure will change, resulting in a population dominated by the elderly and the youth. In many countries, AIDS is erasing decades of progress made in improving mortality conditions and extending life expectancies. The average life expectancy in sub-Saharan Africa is now 47 years, when it would have been 62 years without AIDS. In Botswana, for example, life expectancy at birth has dropped to a level not seen in this country since 1950 (UNAIDS 2002).

Figure 2. Projected population structure with and without the AIDS epidemic, Botswana 2020

Source: United States Census Bureau, World Population Profile (2000)

Shortage of labour

HIV/AIDS poses a direct threat to household food security as it affects the most productive household members. When a person is sick the household not only has to manage without their labour inputs but with the loss of labour from those who have to care for the sick. AIDS is characterized by recurrent periods of sickness, and so recurrent loss of labour, which eventually erodes agricultural production and food security. Much of rural agricultural production is highly labour-dependent and often labour demands are concentrated in specific periods of the year. For instance, sickness or funeral attendance may mean that the planting season is missed and with it, a full crop.

Gross agricultural production is also affected by labour shortages. The FAO has estimated that in the 25 hardest hit countries in Africa, AIDS has killed around 7 million agricultural workers since 1985 and it could kill 16 million more before 2020. The most affected African countries could lose up to 26 percent of their agricultural labour force within a few decades and with agriculture still representing a large proportion of the gross domestic product, this loss in labour could have severe impacts on the national economy (FAO 2001b).

Table 1. Projected loss in total population and agricultural labour force due to AIDS, 1985-2020

Total population

Agricultural labour force













South Africa















Source: FAO (2001b)

Loss of agricultural skills and knowledge

Rural farming systems depend upon a wealth of local agricultural and biodiversity knowledge that is essential for maintaining production. The loss of a productive generation means that livelihood skills including agricultural knowledge are not passed from generation to generation, leaving a young population ill-equipped to manage the impacts of the epidemic. Moreover, agricultural skills are often gender-specific and the sickness or death of a male or female household member can result in a weakening of the farming system.

HIV/AIDS and the impact on smallholder agriculture in Zimbabwe
A study of the impact of HIV/AIDS on smallholder agricultural production in Gweru, Zimbabwe found that:
  • the highest number of deaths was in the 31-41 year age group;

  • extension workers spent approximately 10% of their working time per month attending funerals;

  • livestock and farm implements were sold to find income for funerals and health care;

  • land for crop production was left uncultivated due to lack of labour and agricultural inputs such as draught power;

  • income was lost as a result of the poor management of crops and livestock;

  • failure to herd cattle resulted in thefts and deaths, further depleting resources;

  • irrigation farming was considered more reliable and so farmers would risk taking loans to hire labour knowing that they were certain to make a profit. But there was a tendency just to plant the crop and neglect other tasks which reduced yields and income

Source: Ncube, NM. (1999)

Decreasing nutritional status

HIV/AIDS has direct impacts on nutrition for the individual, the household and the community. For the individual, HIV infection, compounded by inadequate dietary intake, rapidly leads to malnutrition. Persons living with HIV have higher than normal nutritional requirements; approximately 50 percent more protein and 10-15 percent more energy per day is needed (Academy for Educational Development 2001, Woods 1999, James, Schofield 1990). Such interactions have serious consequences for the poor, who are more likely to be malnourished even before they become infected. Malnutrition may hasten the onset of AIDS and ultimately death, and may also increase the risk of vertical HIV transmission from mother to child. The re-occurring periods of sickness of those living with HIV place a strain on the availability of farm labour and, if sustained, on household food production and ultimately the nutritional status of other household members.

Weakening institutional capacity

The rural and agricultural dimensions of the HIV/AIDS epidemic not only present devastating impacts on agricultural production, but also reduce the capacity of rural institutions to provide adequate services. The first impact experienced by formal organizations is a decline in human resources, as more staff are absent due to repeated periods of AIDS-related sickness. The quality of the service is affected as other staff members have to cover for their colleagues’ absence, thus increasing their own workload and decreasing the geographical area which mobile staff, such as extension workers, are able to cover. Organizations also suffer from less tangible results of increasing staff attrition. Certain technical skills can be replaced, but institutional knowledge and experience cannot be easily substituted with new staff. In addition, there are direct budgetary costs associated with continual attrition that can divert organizations’ funds away from operational activities. Informal institutions are also affected by a dwindling contribution from AIDS afflicted households. Constraints on these households’ time and resources reduce their ability to participate in these community networks and in turn, reduce their access to these vital social safety nets and so increase their vulnerability.

Exacerbation of gender inequalities

Gender inequality is one of the driving forces behind the spread of HIV. In order to adequately address gender, it is necessary to consider the wider social, economic, political and cultural context in which inequalities are generated and maintained.

In many places HIV infection rates are three to five times higher among young women than young men. These differentials in HIV infection are partly explainable by biological factors which make women more vulnerable to HIV, especially in youth and adolescence. HIV differentials also reflect age differences between sexual partners, in which men are older and more dominant and tradition and social pressures limit women’s ability to express their wishes regarding their sexuality, their choice of sexual partners and their ability to demand protected intercourse, thus increasing their risk of contracting HIV.

Gender inequalities render women more vulnerable to the effects of the HIV/AIDS epidemic. Rural women’s domestic work loads tend to increase, as they are often the care providers when household members are sick. Access to productive resources, including land, credit, training and technology are strongly determined by gender and frequently favour men in the allocation of resources. As the household asset base dwindles and more members become sick, women’s access to scarce resources is further diminished. Moreover, following the death of a spouse, a widow may not be granted access to household resources resulting in further impoverishment.

Female farmers and HIV/AIDS
  • In Zimbabwe, the 2000 prevalence survey showed that 31.4 percent of pregnant women living in rural areas were HIV positive. Women who listed their residence as "farm" registered a 43.7 percent prevalence rate.

  • In Swaziland, the 2000 surveillance survey showed that 25 percent of the women who listed their occupation as "subsistence farming" were HIV positive. Overall prevalence among pregnant women in rural areas was 32.7 percent.

Source: FAO (2002a)

Using a livelihoods framework

HIV/AIDS, agriculture, food security, rural poverty and mobility, form a complex matrix of inter-relationships and competing forces. The success of any HIV mitigation strategy would depend upon its ability to recognize this wider environment in designing interventions. The livelihoods framework (figure 3) is a useful analytical tool for organising these competing influences and understanding the impact on rural livelihoods. The framework also aims to help different stakeholders engage in a structured and coherent debate. It presents the main factors that affect people’s livelihoods, their relative importance and the way in which they interact to form survival strategies.

Households are seen to possess five sets of livelihood assets essential to their livelihood strategies: human capital, natural capital, financial capital, social capital and physical capital. Utilizing these assets, households adjust to their physical, social, economic and political environments through a set of livelihood strategies designed to strengthen their well being. The contexts in which households operate involve threats that render them vulnerable to negative livelihood outcomes. These threats can include periodic droughts, floods, pest infestations, crop and livestock shocks, economic shocks, conflict and civil unrest, as well as the illness and death of household members.

Figure 3: The livelihoods framework

Source: DFID, FAO (2000)

FAO/J. Holmes

In reference to the diagram shown in figure 3, HIV/AIDS represents a potentially devastating shock to the farm household. The illness or death of one or more household members can affect each of the livelihood assets resulting in a reduction in the ability of the household to adjust to future shocks. This situation, combined with unfavourable structures and processes (represented to the right of the asset pentagon), could result in livelihood strategies that are not sustainable and outcomes that impact a household’s ability to respond and maintain long-term food security.

AIDS orphans, the situation is critical
  • In many countries, sexual intercourse is the predominant mode of HIV transmission and is affecting most people in the 15 to 50 age group, who often have established families. Consequently, large numbers of orphans are left behind when AIDS victims die.

  • By 2002, it is estimated that 13.4 million children have lost one or both parents to the HIV/AIDS epidemic, which is expected to increase to 25 million by 2010.

  • In 2001, 12 countries in sub-Saharan Africa accounted for 70 percent of the orphans.

  • A study in Zambia found that 68% of rural orphans were not enrolled in school compared with 48% of non-orphans.

  • Severe food insecurity among orphans is already reported in the most affected areas.

  • Many children lose their parents before learning basic agricultural skills and nutrition or health knowledge. A study in Kenya showed that only 7% of agricultural households headed by orphans had adequate knowledge of agricultural production.

Source: FAO (2001b) and UNAIDS, USAID, UNICEF (2002)

Table 2: The impact of HIV/AIDS on food security and the implications for households and communities

Impacts of HIV/AIDS on food security


Dramatic changes in the population

Increase in orphaned children

Proportional increase in the elderly

Increase in widows and female-headed households

Decrease in the agricultural labour force

Decrease in the area cultivated, in weeding, pruning and mulching, resulting in a decline in crop variety, yields and ultimately soil fertility

Increase in fallow land returning to bush

Less labour intensive cropping patterns and animal production

Decrease in women’s productive activities due to their role as care providers

Missed planting seasons

Chronic illness or death of a household member

Increase in health expenditure

Funeral costs

Change in household composition

Changes in the age or sex of the household head

Increase in the household dependency ratio

Out-migration of young adults

Increase in the number of orphaned children

Increase in the fostering of orphaned children

Child headed households resulting in reduced attendance or withdrawal of children from school

Change in household nutritional status

Increase in the malnutrition of people living with AIDS and other household members due to the increasing impoverishment of the household

Acute decline in household income

Decrease in farm income sources and the proportion of farm output marketed

Sale of land

Liquidation of savings and slaughtering of livestock to provide income for health care and funerals

Decrease in women’s contributions to household income

Decline in purchased items including food

Increased need for cash income sometimes resulting in sex work

Increase in the need for off-farm income sources

Decrease in credit availability and use

Increase in interest rates and more frequent loan defaults

Decrease in aggregate community income and assets

Reduction in investment

Loss of agricultural knowledge, practices and skills and their transmission from one generation to the next

Decrease in the availability of skilled labour and essential agricultural knowledge for orphan-headed households

Loss of gender-specific agricultural knowledge

Decrease in access to natural resources, especially land

Depletion of resources in close proximity to households, especially water and forest assets

Decrease in biodiversity and the pool of genetic resources

Exacerbation of gender-based differences in access to resources

Increase in gender inequality, resulting in a decrease in access to land, credit and knowledge, for women in general, but particularly for widows

Changes in social resources

Less time available to participate in community-based organizations, associations and other support networks

Increase in social exclusion

Increased stigma associated with HIV, thus increasing the difficulty of maintaining social and kin groups

Decrease in tangible household assets

Poor household maintenance

Increase in sale of household goods, equipment and tools

Degradation of public services

Reduction in the quality and quantity of public service provision

Less maintenance of communal irrigation systems, terraces, roads

FAO/A. Wolstad

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