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:
- a decline in soil fertility
- increases in pests and diseases
- changes and delays in cropping practices
- decline of external production inputs.
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.
