Population People

Posted June 1996

AIDS and Agriculture in Sub-Saharan Africa

by Martina Haslwimmer
FAO Farm Management and Production Economics Service (AGSP)

extracted from "What has AIDS to do with Agriculture?" (FAO, 1994)

Since the first case of Acquired Immunodeficiency Syndrome (AIDS) was recognized in 1981 in the United States, the Human Immunodeficiency Virus (HIV) has spread throughout the world. By the year 2000, the current projection of the World Health Organization (WHO) is that there will be a cumulative total of 30 - 40 million HIV infections in men, women and children, the projected cumulative total of adult AIDS cases is close to 10 million worldwide.

WHO estimates that10 million people have been infected by HIV as of mid-1994 in sub-Saharan Africa. It is further estimated that more than 2.5 million AIDS cases had occurred in this region as of mid-1994. The predominant way of transmission is heterosexual. The disease affects the most productive age group in the population - those between 15 and 49 years of age, a fact which is unique to HIV/AIDS in comparison with other diseases such as malaria or cholera.

HIV/AIDS is a medical problem, but has social and economic dimensions as well. In most sub-Saharan African countries small farmers are not part of a fully operating medical care system. At the family level, medical costs associated with caring for the sick and bedridden have to be borne along with the funeral expenses of family members who die of the disease. Besides the costs of drugs, conventional and traditional medical treatment, households caring for AIDS patients are often faced with meeting expenses for additional special foods to comfort the sick.

The impact of HIV/AIDS on the rural household

HIV/AIDS causes direct costs, mostly medical and funeral expenses, and indirect costs, which are mainly labour-related. Potential income is lost due to illness and death of individuals and the task of caring for these patients. If no safety net is present or is incomplete, small-scale households and rural communities have to bear these costs by themselves. The impact can also affect the development of off-farm activities; the degree to which extension reaches, in particular the small farmer, and the provision of social services. Virtually no sector or sub-sector involved in the planning, design and implementation of agricultural development projects and programmes may thus be regarded as being beyond the reach of effect of the HIV/AIDS epidemic.

HIV/AIDS intervenes and effects farm households, their different sub-systems and their interlinkages. Cash income and labour are partly diverted to cope with and/or compensate for the effect of HIV/AIDS, leaving less labour for farm and off-farm activities as well as reducing the amount of money available to the household. Cash, which is exchanged by the farm and off-farm system in purchasing fertilizer or other inputs or financing investments in off-farm activities, may have to be used to pay for AIDS-related expenditures. Where households own livestock, and there is no cash income, cattle may be sold to pay for medical and funeral expenses.

The high cost of treating AIDS and the expenses incurred through the death of an AIDS victim, mean that households either require assistance or cash incomes to cope with these additional expenses.

At the national level, HIV/AIDS requires budgeting for health and for health education programmes. These expenses involve not only treatment programmes but awareness-building and information campaigns. While much of this work is being undertaken by non-governmental organizations (NGOs), the effective dissemination of information requires the support of governments. Additional costs to governments may also arise from the loss of skilled labour in certain areas, to be replaced by higher-paid international employees and by the import of foodstuffs or other items which may be needed to supplement the loss of production.

The impact on labour

In some rural communities of sub-Saharan Africa, HIV/AIDS is now resulting in labour shortages for both farm and domestic work. Besides the labour loss of the AIDS patient through sickness and subsequent death, family members have to divert time to care for the sick and eventually neglect farm or off-farm activities. This results in a loss of potential income. The situation is aggravated in farming systems with pointed labour peaks in the year and by a marked gender division of labour. With the death of a spouse the widow or widower does not necessarily take over the work of the deceased spouse. Labour-intensive farming systems with a low level of mechanization and agricultural input use are particularly vulnerable to the impact of HIV/AIDS as the economic return to labour tends to be low. In addition, traditional customs like the extended time of mourning, where no farming activities can be carried out, can have an adverse effect on labour availability during periods in which deaths are frequent.

The impact of HIV/AIDS on small farmers

The impact on crop production The impact of HIV/AIDS on crop production relates to a reduction in land use, a decline in crop yields and a decline in the range of crops grown. The reduction in land use is attributed to a number of factors which have occurred as a direct result of the HIV/AIDS epidemic. These include: sickness and death in households, leading to fewer family members being available to work in the fields and thus in the size of land that can be cultivated; the limitations of land inheritance and land tenure systems, especially as they may affect widowed and orphaned households; poverty, resulting in malnutrition, which in turn affects the health of family members and their ability to perform agricultural work, and which leads to reduced cash incomes needed to purchase inputs such as seed and fertiliser; and the loss of soil fertility on farms with limited areas cultivated. The effect of HIV/AIDS in reducing the number of family members needed to cultivate larger areas of land, has led to substantial reductions in land use in many communities. In some communities, where land tenure and inheritance traditions favour male inheritance, the effect of the HIV/AIDS epidemic may be especially severe. As increasing numbers of women are left widowed, and their right to land is already constrained by traditional inheritance customs, their access to land becomes extremely difficult.

Decline in crop yields

In several farming systems examined by the FAO study, a decline in the crop yield per area, especially in the last five years could be observed. The factors for the decline include: These factors are in part attributed to the effects of HIV/AIDS in limiting the availability of labour for tasks like weeding, mulching, pruning, as noted above, and the clearing of land. These tasks are either inadequately carried out, or completely neglected. Declines in yields result in a reduction in household spending power. Cash from the sale of products to buy basic items like soap and paraffin and to hire occasional labour, or to purchase inputs such as seed and fertiliser as well as agricultural implements may not sufficiently available anymore.

Decline in soil fertility

There are signs that the HIV/AIDS epidemic is reducing soil fertility. This appears to be due, in part, to a reluctance by farmers to carry out long-term soil conservation measures because such measures do not yield an immediate income and are labour demanding in an environment in which the farming system is already short of human resources.

Increase in pests and diseases

One of the phenomena occuring in crop production systems which are highly dependent on farm labour, is the increasing incidence of pest and plant diseases. The loss of labour, as a result of AIDS, has reduced the amount of time, care and cash required to effectively carry out cultural practices and/or pesticide use by, in particular, small farmers. In the coffee-banana system the banana weevil which destroys banana plantations, and stinging ants which make it difficult to work on coffee plantations are affecting yields. Banana weevils used to be controlled either by traditional means, which are labour-intensive, or with the use of chemicals. A shortage of human resources hinders farmers from controlling weevils using traditional methods moreover they do not have the financial resources to purchase chemicals. Similarly, in the coffee plantations, increasing infestations of large stinging ants are believed to be symptomatic of poor cultural practices. In some cases this has resulted in the plantations having reverted so far that it is no longer economic for all but the wealthiest or most labour-endowed households, either to recover their old coffee trees or open new lands for coffee production.

Decline in the variety of crops grown

A general shift was observed away from crops that are labour demanding, like bananas and coffee, to those that are easy to plant and maintain, require less labour and are also drought resistant. A narrower range of crops are being grown in East Africa, with greater emphasis on sweet potatoes, cassava, and maize. Other reasons for the decline in the range, as well as in the volume of crops include: the depletion of soils, lack of labour, the high incidence of pests and diseases, are at least partly attributable to the frequent deaths and sickness of farmers and their children caused by AIDS. In order to adapt to factors caused by AIDS farmers have responded by changing their cropping patterns. In some farming systems this has resulted in a shift away from the cultivation of cash crops such as coffee in order to concentrate all available labour on the production of subsistence crops like sweet potatoes and cassava.

Livestock production and pastoralism

The impact of the HIV/AIDS epidemic on livestock-raising practices has been felt in several ways: cattle are frequently sold to pay medical bills and funeral expenses and decreases in labour availability result in lower levels of care of livestock. Partially as a result of the latter, there appears to be a parallel trend towards the keeping of smaller stock, most notably pigs and poultry, which are less labour demanding.

Little is known about the impact of HIV/AIDS on pastoralists. One example from Uganda's Rakai District, a predominantly pastoralist tribe, maintains close relationships with the crop farmers and practices social traditions which favour the spread of HIV/AIDS: several brothers may share one wife. Among these pastoralists there has been a tendency for herd sizes to become smaller. While one of the reasons given was due to the outbreak of the disease, Contagious Bovine Pleuropneumonia, another reason is HIV/AIDS. As with sedentary cattle keepers, people who fall sick sell their animals to pay for drugs, hospitalization and other expenses.

The impact of HIV/AIDS on the agricultural extension services

The effect of HIV/AIDS on extension work in areas of high epidemic incidence may be two-fold: in one case a local extension officer in Uganda noted that between 20 and 50 percent of all working time was lost as a result of the disease. Staff members were frequently absent from work attending funerals and caring for sick relatives; in some cases extension messages have had to be revised to take into account the impact of the disease on agricultural systems, i.e., the shortage of labour, changes in farmers' needs and priorities both in crop and livestock production systems.

The loss of agricultural knowledge and management skills

Case studies undertaken in rural areas with high levels of seroprevalence make repeated references to the loss of traditional knowledge and cultural practices, in part attributed to HIV/AIDS-related morbidity and mortality. When one or both parents die or are seriously ill, their skills may not be transferred to their children or other relatives. This may have far reaching implications in terms of the continuity of agricultural production. In Eastern Africa, where the cultivation of coffee and bananas has been a traditional feature of the farming system, cultural practices associated with coffee and banana tree cultivation may be essential towards ensuring the system's continuity. As has already been noted, the correct mulching, weeding and pruning of plantations is a prerequisite for reasonable yields. However, in areas where there is a high incidence of HIV/AIDS, and the subsequent lack of understanding of the correct agricultural practices, plots have been neglected resulting in poor yields.

The consequences of HIV/AIDS

The consequences of HIV/AIDS on farming systems

The consequences of the HIV/AIDS epidemic on rural populations and agricultural systems include: the threat to household and community food security; a decline in the nutritional and health status of smallholders and their families; a decline in educational status, as children are forced to leave school; and changes in the social system, as households adapt to the impact of HIV/AIDS (i.e. the break-up of families, a growing incidence of female-headed households, and increasing number of orphans and rural poor). The impact of HIV/AIDS is also likely to be most severe among already vulnerable groups such as the malnourished and the food insecure. Individuals and groups have begun to develop survival strategies in the light of the changes which are occuring, partially as a result of the impact of HIV/AIDS on their lives. For example, in a number of cases farmers have expressed interest in supplementing their incomes through small income-earning activities like bee keeping, tailoring, pig keeping, etc. Smallholders have also shown a growing interest in receiving extension advice, skills training or education (basic literacy, numeracy, health education, etc).

The declining status of nutrition and health

In severely AIDS-affected communities there has been a change in the volume and kinds of crops produced in the farming systems. Partly as a result of this the process of impoverishment is induced that levels of nutrition are falling due to the reliance on starchy staples like cassava and sweet potatoes in Eastern Africa, compared with other more nutritious but labour-intensive traditional crops and or protein from animal products. In addition there is the lack of understanding of the nutritional value of foods. Lower levels of nutrition result in the increased vulnerability of people to disease and thus to an overall decline in health.

The problem of orphans

With increasing numbers of children left orphaned by HIV/AIDS-related deaths or departure from home of their parents, the health, well-being and education of such children is a special problem. If orphans are provided for by relatives, the cost of maintaining and educating these children may strain the resources of the receiving households. Orphaned children generally cannot pay school fees or buy uniforms and other school necessities such as exercise books and text books. In areas with a high incidence of HIV/AIDS and orphaned children, NGOs have been playing an important role in providing housing, and financial, educational and health assistance.

Coping mechanisms: the role of NGOs and self-help groups

At the level of the farming system, some coping responses have already been touched upon. At the level of the community as a whole, the most important response has been the formation of self-help groups, some spontaneous and some under the aegis of an NGO. This is an important development in societies where cooperation between individual households is not the norm. It suggests that the traditional response may provide a firm base for future efforts to cope not only with the impact of the epidemic, but also with the wider problem of poverty which forms the background to that impact. A number of NGOs in providing advice to farmers and extension staff in animal and crop husbandry practices, have shown their work to be especially pertinent in communities where sickness and death from HIV/AIDS have left some households composed of orphans and in need of resources, both in terms of financial assistance and education, health and other basic services.

The impact of HIV/AIDS on programmes and projects

Rising mortality and morbidity as a result of AIDS are likely to have an impact on project performance since health is a precondition for development. One of the most serious threats to any project is absenteeism on the part of both beneficiaries and project staff, which can be caused by mortality and morbidity, attendence to funerals and various other exigencies of daily life. Absenteeism from project activities may set back the progress of projects in countries severely affected by the disease. Discrimination at the workplace of HIV-positives staff may further interfere with the work performance of all staff.

The impact of AIDS can manifest itself in various ways. It may result in labour shortages forcing farm households to shift from cash to subsistence crops when food security is being threatened. Cash crops which require a long investment period may not be suitable for families afflicted by AIDS that are in need of quick returns to cover immediate medical, funeral or orphan-related expenses.

Livestock activities might be jeopardized by family members selling off their animals to finance medical care for AIDS patients. In addition, if the person in charge of the livestock dies, family members are often unable to manage the livestock due to the loss of skills and relevant experience.

The viability of agricultural credit schemes may be at risk as a result of HIV/AIDS for three reasons: a) increased mortality may raise the number of defaults; b) AIDS-affected families may be forced to liquidate their assets in order to repay the credit or else have their assets seized, thereby ending up worse off than before they incurred the credit; and c) AIDS-afflicted families may have to spend part or all of the credit to finance medical care for family members suffering from AIDS, rather than use the funds for investment. Agricultural research priorities might shift in view of AIDS to focus on the special needs of farm household with fewer working adults. Projects supporting agricultural extension services need to ensure that forms of labour-substitution, technical advice and credit services are made available to AIDS-affected farm families. Such projects should review the impact of HIV/AIDS both in terms of increased mortality among agricultural extension staff, but also in terms of the reduction of the work time as a result of the increase in funeral attendence.

In countries or regions where AIDS is claiming the lives of skilled labour and the labour market is limited in this labour segment, consideration of the impact of AIDS may be critical to the success and sustainability of investment projects. Recruitment, personnel replacement, training strategies and employment benefits (medical, pension funds, etc) may have to be revised accordingly.

For any training activity, HIV/AIDS may have to be taken into account both in terms of replacement/re-training provisions and strategies, but also in terms of revising training curricula.

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