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Stakeholder Workshop on the food situation in Zimbabwe - October 2002
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3. HIV/AIDS and the Humanitarian Crisis
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- by Mrs P. Mujuru from UNAIDS
Mrs Mujuru passionately explained the link between food shortages and HIV Epidemic. She summed up her explanation by reading out the following citation from SAFAIDS News:
“Nutritional status and food security are key components of health and quality of life for people living with HIV/AIDS. Food shortages reduce nutrition levels, resulting in reduced immunity … and consequently increase in the number of people who succumb to AIDS”.
She then went on to capture the seriousness of the problem through facts and figures as shown below.
HIV/AIDS Situation 1
- An estimated 700 000 people have full blown AIDS
- 2500 people are dying of AIDS every week
- 2 million people living with HIV/AIDS
- It is estimated that 60-70% of deaths among children under the age of five are attributable to HIV/AIDS
- 26-30% sexually active adults (15-49) are infected
HIV/AIDS Situation 2
- More than 700 000 living children have lost one or both parents to AIDS
- The majority of new infections are occurring in young adults, with girls and young women of 15-24 years particularly vulnerable (5 to 6 times more liable to risk of infection than boys and men of the same age)
Mrs Mujuru put HIV/AIDS in the context of the current humanitarian crisis. She noted that an estimated 6.1 million (51% of the country’s population) will need humanitarian assistance for the next 18 months. About 5.9 million of these are rural people (74% rural) who will be affected by the drought, 1.9 million urban poor (51% urban) are heavily affected by the prevailing harsh economic situation. At most 69% of the 7.8 million are children between 0-14 years, 23% are aged below five years and 46% are aged 5-14 years.
The current food shortage is taking place in the context of a severe HIV/AIDS epidemic. Families already affected by HIV/AIDS are less able to cope with the famine. Coping mechanisms that saved lives ten years ago may now facilitate the spread of HIV/AIDS. The
current drought unlike other droughts in the past has been aggravated by the HIV epidemic. It is widely acknowledged now that people with HIV are precipitated into AIDS if faced with
poor nutrition and stress, shortening their life expectancy and diminishing their quality of life.
Mrs Mujuru informed the participants that during food crisis, affected populations adopt a variety of coping mechanisms e.g. finding additional sources of food or income, migrating, dropping out of school, engaging in hazardous work, exchanging sex for food or cash. She said that the impact of the food crisis on HIV positive people and their families can be observed through higher rates of malnutrition which is generally evident amongst adolescents and adults due to HIV. Insufficient food leads to micro-nutrient deficiencies making PLWHA more likely to succumb to opportunistic infections. Intra-familial distribution of food may also change. Children and HIV positive breast feeding mothers may be given low priority in food distribution, leading to their rapid decline.
She highlighted some factors that constrain the ability of HIV/AIDS affected people from coping with their conditions within the context of drought and food insecurity. She noted that families of people living with HIV are made vulnerable due to their diminished labour capacity. Diminished agricultural productivity and ability to work for cash may lead families to sell their assets, reduce levels of childcare and lead into a cycle of increased poverty and deprivation. The situation exposes families to more unsafe water sources which then result in increasing deaths due to diarrhea (ref. Cholera outbreaks in Zaka, Bikita). There is also need to examine whether families affected by HIV/AIDS have less access to food assistance due to limited mobility and/or stigma and discrimination. She concluded her presentation by opinionating on what needed to be done. In her opinion, there is need for Policy advocacy to lobby food distributors to mainstream HIV/AIDS into their efforts, lobby for networks of ASOs and NAC structures at District level to be involved in food distribution, lobby for keeping both girls and boys in school as long as possible to reduce their vulnerability, including sexual
exploitation.
Mrs Mujuru suggested strategies to be considered to mitigate the impact of HIV/AIDS and food insecurity. These have been broken down into four:
a) Free Schooling
- There should be high level governmental advocacy for free schooling. The following
should be considered:
- Provision of lunch (or school feeding scheme) in schools and hospitals/clinics
- Work with teachers and headmasters to follow-up on children that drop out of school.
b) Protection of women and children
- Lobby for the protection of women and children at food distribution sites to ensure that they do not suffer from violence (extortion, sexual violence, etc).
- Lobby for interventions such as the provision of low labour crop seeds in high HIV prevalence areas.
- Government departments, NGOs, Private sector involved in food distribution must work with home based care programs to reach PWAs and their families.
c) Monitoring
- Monitor the impact of the drought on increased vulnerability to HIV infection.
- Understand migration patterns and their possible links to HIV (e.g. movement of people from high to low prevalence areas , from rural to urban areas where the potential for sexual mixing increases).
d) Monitor child – headed households
- Monitor children living in child headed households or on the streets to ensure that they have access to sufficient assistance and do not resort to harmful coping mechanisms.
- Meet with parents and community leaders to motivate continued school attendance
3.1 Plenary Session
During the plenary session a number of questions were raised. Participants wanted to know how AIDS could be mainstreamed in the face of the confidentiality associated with it. Mrs Mujuru indicated that when it comes to the rural areas the issue of confidentiality is rarely upheld. Those who are chronically ill, whether from AIDS or other diseases, received free food hand outs from government. Included in this group of those who receive free food are the elderly and the disabled. The able bodied are engaged in food for work programs where they earn some income which they then use to purchase their food.
The participants asked the presenter on what was being done to serve the “window of hope”, those between the ages of 6-24 years, which was now narrowing due to HIV/AIDS. It was noted in response that a number of interventions have been initiated to address this problem. One example that was given is the support that UNAIDS gives to the Ministry of Health in order to support its youth programs. Pilot projects in Masvingo, Harare and Bulawayo were cited. A private initiative called “In God’s Arms” shields the youth, especially the orphaned or the very poor, from abuse by providing decent accommodation and necessities while they remain in the custody of their relatives. The church is used to identify those children in need. Funds are made available also for medical treatment, life skills training and technical skills.
Some participants were however of the opinion that UNAIDS should not channel funds through the Ministry of Health, but should direct the funds to those groups that work with the youth.
Concern with the sexual exploitation of children by those distributing food was raised. Mrs Mujuru informed the workshop participants that AIDS awareness programs are being taken to the food distribution points. These are in the form of drama, counseling and provision of security by the civil protection unit or the ZRP.
The success of Uganda in reversing the prevalence of new HIV/AIDS infections was seen as a sign of political commitment to fight the scourge. It was observed that although the political commitment in Zimbabwe did not take the form and content that it took in Uganda, it was shown in that Zimbabwe is probably the only country in Africa that has introduced a levy, specifically directed at combating HIV/AIDS.
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