Once a largely urban problem, AIDS has moved to rural areas in
developing countries, devastating thousands of farming communities
and leaving impoverished survivors scarcely able to feed themselves.
The disease is no longer a health problem alone, but is having
a measurable impact on food production, household food security
and rural people's ability to make a living.
The latest statistical evidence issued by the Joint United Nations
Programme on HIV/AIDS (UNAIDS) on sub-Saharan Africa -- the worst-hit
region -- confirms the scale of the epidemic's impact on the countryside.
UNAIDS estimates that over half of the 28 million people living
with HIV/AIDS in sub-Saharan Africa live in rural areas. In order
to estimate such figures, UNAIDS epidemiologists start with data
taken from tests done on blood samples from pregnant women attending
prenatal clinics. They then extrapolate the figures to estimate
infection rates in larger areas. Recent findings point to two
of the hardest-hit countries:
Zimbabwe, where 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. Such figures mean
that over 1 million people in rural areas have HIV/AIDS
Swaziland, whose 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. Such figures mean that
over 100 000 people in rural areas of this small southern
African country, out of a total population of 938 000, have
"This is a real wake-up call for governments," says Marcela Villarreal,
FAO focal point on AIDS. "Policy-makers are guided by evidence.
Solid evidence is now coming in and will make governments understand
how rural areas are actually more vulnerable to AIDS than urban
Recent reports from other African countries show a similar pattern
of rampant rural infection.
In an FAO-supported study commissioned by Uganda's Ministry
of Agriculture, Animal Industry and Fisheries, researchers surveyed
300 households in five rural districts in late 2001. The majority
of the households (91 percent) had lost a family member in
the preceding 10 years, mostly in the 20-35 age bracket.
AIDS caused 56 percent of the deaths.
Study author Narathius Asingwire, of Makerere University in
Kampala, says that the deaths of so many farmers in the prime
of life has far-reaching implications for the country, since agriculture
accounts for 43 percent of GDP, 85 percent of export earnings
and 80 percent of employment. In addition, 85 percent of
Uganda's 22 million people live in rural areas and depend
mainly on agriculture.
Asked to comment on the effects of HIV/AIDS in their households,
two thirds of households replied that they now grow less food,
over two thirds reported producing fewer cash crops and over half
said they were eating less. The following statistic spells trouble
for the many rural landless who depend on casual farm labour to
survive: 85 percent of respondents said they were using less
Survey respondent Paulo, 80, supports five young grandchildren
orphaned by AIDS. He has a banana plantation, but the biggest
part is overgrown with weeds due to lack of labour. There has
been a sharp reduction in food consumption among his family members
-- they now only get one full meal a day, in the evening, eating
just some porridge for lunch.
"Even now when I am still alive, we do not have enough to eat,"
says Paulo, who is ill and cannot work to augment the family income.
Pointing to the youngest grandchild, he says, "You can see that
young one is gloomy not because he is sick or has been punished,
but because he has not eaten anything since morning."
In Kenya, the latest figures from the Ministry of Agriculture
and Rural Development predict that the total number of lost workdays
in the agricultural sector due to HIV/AIDS will reach 329 000
person years in 2020, if present trends continue. In 1990 the
figure was 45 000 person years.
The district of Bondo in western Kenya has been particularly
hard hit by the virus, with about 29 percent of the population
infected, according to a 2000 survey, says Kenneth Ayuko, leader
of an FAO community support team in Kenya. In some communities,
as many as half of the adults are HIV positive.
"We have grandparents having to take care of up to 20 or even
30 orphans, and that takes a very big toll. Therefore, it is probably
correct to say that food production under these circumstances
of the HIV/AIDS pandemic is not possible," he says. "No wonder
that the bulk of the population in Bondo is going hungry."
Poverty underlies the suffering and devastation behind these
figures, says Ms Villarreal. "The HIV/AIDS epidemic cannot be
addressed without doing something about rural livelihoods: how
people make their living, how they get enough food, what strategies
they follow in order to survive," she says.
FAO is currently formulating pilot projects that will test labour-saving
techniques and low-input agriculture in African and Asian communities
hard hit by the epidemic. Other priorities for the FAO HIV/AIDS
programme include building up institutions that help rural communities,
improving nutrition, addressing gender inequalities in access
to productive resources (especially land) and helping decimated
communities find a way to pass on farming knowledge to the young.