FAO was the first UN agency to initiate detailed sectoral analysis of the socio-economic impact of HIV/AIDS on rural economies. Thus, right from the beginning, FAO perceived the HIV/AIDS epidemic as a development problem of critical importance, rather than simply a health issue.
There seems to be growing consensus that the HIV/AIDS epidemic will not be contained as long as it is regarded as only a health sector issue and not placed within the overall context of development. A strong political commitment to fight the epidemic is necessary to enable a comprehensive and integrated approach to alleviate the widespread impact of the disease and to address issues of poverty and powerlessness. Many governments in sub-Saharan Africa are in the process of developing a national strategic plan for a multisectoral response to HIV/AIDS. This exercise has evolved with the assistance of the Global AIDS Program me (GPA/WHO) and is now followed up by the Joint United Nations Program me on HIV/AIDS (UNAIDS). In these plans each of the key sectors is assigned activities based on their comparative advantage. Ministries of agriculture need to participate in national AIDS control programmes and discuss with the authorities of other relevant sectors the role of agriculture in a multisectoral approach to HIV/AIDS.
In view of the rapid spread of the HIV/AIDS epidemic in rural areas, especially in sub-Saharan Africa, socio-economic and cultural research (through rapid assessment surveys) needs to be conducted on the impact of the disease on agricultural production systems, household food security, traditional coping mechanisms, etc. to enable the development of appropriate prevention and mitigation strategies. The following considerations and activities are suggested to launch joint HIV/AIDS prevention and mitigation strategies for rural households/communities:
* Research into the location-specific agricultural impact of the disease is necessary. For example, research may be directed towards the development of crops that require less labour but are nutritious, cultivation practices that are less labour-intensive and labour-saving conservation technologies.
* Agricultural education and training policies need to take account of the gender implications and the socio-economic impact of the epidemic on rural households/communities.
* National AIDS control programmes should advocate enactment/enforcement of legal reforms to protect vulnerable groups, especially HIV/AIDS widows and orphans, focusing on land tenure, inheritance, access to assistance and inputs.
* Specific population groups most affected by the disease must be targeted for education, training and assistance. Special attention should be given to girls who are taken out of school to work and take care of the family. Agricultural extension programmes need to collaborate with other technical agencies and relevant NGOs in specific areas to promote HIV/AIDS prevention campaigns complimented by problem-solving interventions for the most affected households and/or communities.
* Development agencies, especially agricultural extension and relevant NGOs, need to take account of the implications of HIV/AIDS in all their outreach activities. Rural development policies that take account of the effects of the disease can reduce its impact. Participatory and problem-solving extension programmes that improve farmers' social and economic conditions and reduce dependence on migration and prostitution will reduce transmission of the disease.
* Rural households and communities develop and adapt their own coping mechanisms. Agricultural extension programmes in collaboration with other agencies and NGOs should support and assist this process.
* Improvement in women's social and economic status is a crucial step for increasing their ability to protect themselves and their families and children from the epidemic. Gender-sensitive agricultural extension programmes can make an important contribution in this regard.
* Rural development policies in sub-Saharan Africa need to take account of the growing labour constraints and the potential widespread disruption to the rural economy and social structure.
* Whatever the extent of HIV infection in the population, governments need to undertake extensive awareness and education programmes. Low rates of infection provide an opportunity to effectively prevent the spread of the epidemic. High rates of infection require urgent measures.
* Whatever the extent of HIV infection in the population, governments need to provide an integrated response to the epidemic. National HIV/AIDS control programmes must be broad-based and involve all government and non-governmental agencies, including ministries of finance, health, agriculture, education, etc.
* Many countries have already established, under the coordination of UNAIDS, a UN-theme group on HIV/AIDS. The representatives of UNFPA and FAO should participate in this exercise and bring the issues of HIV/AIDS-related impact on agricultural production and rural households/communities before this theme group in order to define the role of the Ministry of Agriculture in an overall national strategic plan for HIV/AIDS prevention and mitigation.
* Technical assistance agencies, including FAO, should combine their efforts to improve the existing mitigation and prevention strategies to combat the disease in rural areas.