Preface

The links between nutrition and infection are well known. Good nutrition is essential for achieving and preserving health while helping the body to protect itself from infections. Consumption of a well-balanced diet is essential to make up for the loss of energy and nutrients caused by infections. Good nutrition also helps to promote a sense of well-being and to strengthen the resolve of the sick to get better. The nutritional advice in this manual can help sick people, including those living with HIV/AIDS, to feel better.

Few crises have affected human health and threatened national, social and economic progress in quite the way that HIV/AIDS has. The pandemic has had a devastating impact on household food security and nutrition through its effects on the availability and stability of food, and access to food and its use for good nutrition. Agricultural production and employment are severely affected and health and social services put under great strain. Families lose their ability to work and to produce. With worsening poverty, families also lose their ability to acquire food and to meet other basic needs. Time and household resources are consumed in an effort to care for sick family members, partners may become infected, families may be discriminated against and become socially marginalized, children may be orphaned and the elderly left to cope as best they can.

Meeting immediate food, nutrition and other basic needs is essential if HIV/AIDS-affected households are to live with dignity and security. Providing nutritional care and support for people living with HIV/AIDS is an important part of caring at all stages of the disease. This manual provides home care agents and local service providers with practical recommendations for a healthy and well-balanced diet for people living with HIV/AIDS. It deals with common complications that people living with HIV/AIDS experience at different stages of infection and helps provide local solutions that emphasize using local food resources and home-based care and support.

The manual was developed following an extensive review of existing guides from both developed and developing countries. Though it is applicable to many real life situations, users may find that they can further improve its usefulness if they adapt sections to local circumstances. The manual was prepared by the Nutrition Programmes Service of the FAO Food and Nutrition Division (ESN) in collaboration with the WHO Department of Nutrition for Health and Development (NHD), Geneva, and is jointly published by FAO and WHO.

Special thanks are due to Maren Lieberum, FAO, who had the primary responsibility for drafting the manual and co-ordinating its preparation and field testing. We would also like to thank Randa Saadeh, WHO, for her technical guidance and oversight of the manual's preparation. We would like to express our appreciation for the valuable contributions made by Marylou Biljsma, University of Zimbabwe, Yvonne Foreseen, Concerned International Angola, Boitshepo D. Giyose, Commonwealth Regional Health Community Secretariat Arusha, John Hubley, International Health Promotion Consultant, Dorcas Lwanga, SARA/SANA Project-USAID, and Micheline Ntiru, Care International South Africa; also to Jethro Dennis, Caribbean Food and Nutrition Institute for preparing the drawings, as well as to Genevieve Becker, WHO consultant, registered dietician and researcher.

Acknowledgements are due Marcela Villarreal and Carol Djeddah of FAO's Population and Development Service and to Ester Zulberti and Kalim Qamar in the Extension, Education and Communication Service for their technical contributions. We also acknowledge the staff of ESNP who assisted in preparing the manual: William D. Clay and Brian Thompson who supervised its preparation; Peter Glasauer who initiated the work and along with Ellen Muehlhoff, Valeria Menza, and Karel Callens provided technical support, and Karen Rautenstrauch and Joanna Lyons who provided editorial and administrative support.

We hope that local service providers, NGOs and family care givers will find this manual useful in their efforts to provide effective and innovative nutritional care and support to people living with HIV/AIDS.