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Food insecurity and AIDS: A vicious circle

The links between AIDS, food insecurity and poverty are strong and deadly. The epidemic is undermining the progress made in the last 40 years of agricultural and rural development. At the same time, growing poverty and food insecurity are increasing rural people's vulnerability to AIDS.

From AIDS to food insecurity and poverty
In households affected by HIV/AIDS, the problems begin as soon as the first adult becomes sick.

Those suffering need the help of their kin, so the family loses not only the labour of the sick but also of other relatives. The situation worsens if other household members get the disease. The family budget is squeezed to pay for medical bills and, ultimately, funeral costs. Soon, there may not be enough money to buy seeds and other inputs, forcing the sale of livestock and other assets. Nor is there money to hire or replace labour.

In a subsistence-level farming community, where there are few tractors and other machines, working hands are crucial. In eastern Africa, labour shortages caused by HIV/AIDS have led to a range of farm changes, including a reduction in land under cultivation, a decline in crop yields and a shift from cash crops to subsistence crops. Agricultural knowledge and skills are also being lost as the knowledgeable generation dies. Children -- girls in particular -- are frequently withdrawn from school to help the family, a trend with ominous implications for the future.

• According to a recent FAO/UNAIDS study, agricultural output of small farmers in some parts of Zimbabwe may have fallen by as much as 50 percent in the past five years, mainly because of AIDS. Over 50 percent of deaths in the areas studied were attributed to AIDS -- 78 percent of them men.

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	HIV/AIDS jeopardizes household food security. When a family member dies, the food consumption of all surviving household members often declines, resulting in malnutrition (Zambia/FAO/A.Conti)
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	Source: UNAIDS
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With so many workers dying, incomes are even more limited, reducing families' capacity to produce or buy food and further threatening overall food security.

AIDS also has implications for nutrition. The onset and progression of the disease are delayed in well-nourished HIV-infected people. But access to adequate food is threatened for all family members in affected households. When a family member dies, the incidence of stunting (low height for age) increases among orphans, and the food consumption of all surviving household members often declines, resulting in malnutrition.

A study in Namibia shows widespread sale and slaughter of livestock to support the sick and to provide food for the mourners at funerals. This loss of assets jeopardizes the long-term nutrition of households as well as longer-term sustainability of development.

From food insecurity and poverty to AIDS
Poverty makes people increasingly vulnerable to HIV/AIDS. Families lacking sufficient nutritious food are more vulnerable, as poor nutrition is closely linked with poor health. This in turn makes a person more vulnerable to HIV infection and can shorten the incubation period of HIV, meaning that symptoms appear sooner. And the situation is worst for the poor, who have the least access to medical care.

Poverty also makes AIDS education difficult, given poor people's lower levels of literacy and limited access to mass media and health and education services, particularly in rural areas. In addition, people struggling with daily survival are less inclined to worry about the long-term implications of illness and therefore are less likely to take preventive measures.

Poverty also increases migrant labour, family break-up, landlessness, overcrowding and homelessness -- factors that increase the likelihood of having multiple sexual partners.

Poor women are especially vulnerable. They tend to be ill-informed on health matters and have little power over any aspect of sexual relations, meaning they are at high risk if their husbands are infected.

  The Joint FAO/UNAIDS study "Sustainable Agricultural/Rural Development and Vulnerability to the AIDSEpidemic" is available free of charge from UNAIDS.
HIV/AIDS and nutrition: helping families and communities to cope (click here for the PDF version)