All famines have long-term roots in uneven development .The fundamental difference (in this current crisis) is the influence of HIV/AIDS-related morbidity and mortality. This both worsens and is exacerbated by the food crisis, creating a dual tragedy.
AIDS increases dependency ratios and weakens economic and food security. This occurs at all levels from the individual and households through to national and regional economies. Food production from subsistence to small-scale and large-scale agriculture is jeopardised by the loss of labour, leading to lower outputs, a narrower range of cropping and poorer livestock management. Thus AIDS increases the vulnerability of populations to famine when other factors such as drought, policy issues and other concerns arise. ( Consensus Statement)
The opening plenary presentations provided a context for understanding the present humanitarian crisis confronting Southern Africa and in particular the potential destabilising impact that HIV/AIDS has on all levels of society, the region and the continent.
Michel Sidibe, Director of the UNAIDS Country and Regional Support Department, pointed out that in some respects the HIV/AIDS pandemic resembles science fiction as it is a unusual disease associated with an intimate act of pleasure which creates life, but that it is not fiction but a reality that could result in illness and death. He described the present crisis as a double tragedy, highlighting that both emergencies are interlinked and that in a world with AIDS, rural development, food security and agricultural policies could not be separated from HIV/AIDS.
Drawing upon comparisons between previous famines and the present famine confronting Southern Africa, Mr Urban Jonsson, Regional Director of the UNICEF Eastern and Southern Africa Regional Office (ESARO), noted that in the famine that struck the region in 1980 and 1992, societies did cope and did come back despite the fact that many of these countries were in a state of instability. However, today in a state of peace many countries are struggling to cope with the present humanitarian crisis. The fundamental difference between the previous famines and the famine confronting the region today is the impact of HIV/AIDS which has now been around for two decades.
Most participants noted the negative impact of HIV on the agricultural sector. Mr Sidibe noted that approximately 7 million agricultural workers in the region have succumbed to HIV/AIDS. Ms Deborah Saidy, Deputy Emergency Coordinator of WFP Southern Africa, delivered the plenary address on behalf of Ms Judith Lewis, Regional Coordinator for the Special Envoy of the Secretary-General for Humanitarian Needs in Southern Africa, highlighting that there is a two directional relationship between HIV/AIDS and food security. She pointed out that HIV/AIDS is impacting negatively on food production, resulting in declines in household incomes and that the present emergency is stretching the resources of the various sectors of society to respond to the additional requirements. Mr Bunmi Makinwa, Team Leader of the UNAIDS Inter-country Team for Eastern and Southern Africa, pointed out that HIV/AIDS was impacting on development in general, resulting in decreased life expectancy and a loss in labour force. In this regard he noted that in Namibia, 25% of the agricultural labour force will be lost to HIV/AIDS and in Malawi close to 16% would be lost to the epidemic.
However, it was evident from the presentations that the present humanitarian and HIV/AIDS crisis pose additional challenges to those infected and affected by HIV/AIDS.
All presenters underscored the need for people living with HIV/AIDS to maintain their intake of food and noted that better and more nutritional foods were required by People Living with HIV/AIDS (PLHAs) to enable them to sustain their health. Ms Sian Long, Regional HIV/AIDS Adviser, Southern Africa for Save the Children Fund UK (SC UK), cautioned that food distribution policies targeting PLHAs needed to be sensitive to issues of stigmatisation and discrimination.
The impact of the present crisis on women and children in particular were highlighted. Mr Sidibe noted that HIV/AIDS in sub-Saharan Africa predominantly affects women, who are the primary producers of food, and are the most affected by HIV/AIDS. Ms Long, of the Save the Children Foundation, reminded participants that in the context of the present crisis it is largely the responsibility of youth and women to collect and distribute food, making them vulnerable to exploitation and abuse by humanitarian relief workers. She called for programmes to be instituted that sensitised humanitarian workers to their own vulnerability to HIV/AIDS.
Mr Jonsson reminded the participants that the present crisis is altering the dependency ratio normally observed during crisis placing a greater burden on the young and the old. He highlighted that in most famines it's the young and the old that die off. With the presence of HIV/AIDS, it is adults at their most productive age, who would normally care for the old and the young that are dying first, placing the burden on young people and the elderly. Ms Long added that the present crisis is forcing children and young people from the rural areas to seek employment in urban areas. This reduces their access to social support and increases their risk of infection. She highlighted that young people's schooling is being undermined through poor planning by food distributors as many were forced to leave their schools to go and get food.
All speakers underscored the need for future actions to reinforce and build upon existing programmes. In this regard, Mr Sidibe called for the mainstreaming of HIV/AIDS into existing components of humanitarian assistance, to utilise the present crisis to increase advocacy for HIV/AIDS, and to piggy back HIV/AIDS activities onto relief efforts. For the United Nations, he emphasised that the present crisis afforded the opportunity for joint programming, a pooling of resources and the more effective utilisation of existing expertise to address in a more accurate manner the crisis that is being faced. Echoing these sentiments Ms Saidy of the WFP suggested that participants should think broadly about how the UN could work together and determine concrete steps that could be taken in the future. She called for the meeting to investigate how current programmes could be refined rather than proposing new programmes. She noted that the meeting needed to develop an understanding of the linkages between HIV/AIDS and the present emergency so as to ensure that donor resources could be best directed towards supporting efforts.
Ms Long, however, pointed out that it was not only UN Programmes that require an examination of programmatic linkages but that the linkages between HIV/AIDS and agricultural programmes in general need to be strengthened.
Regarding political commitment in the region, most speakers emphasised the need for greater action and commitment. Mr Urban Jonsson concluded that "war criminals are brought to tribunals for justice. How long are we going to be silent about the silence? It is no longer bad governance; it is criminal that African leaders and senior politicians are silent around issues of HIV/AIDS."
The discussion following the plenary was utilised by many agencies to highlight previous work undertaken on HIV/AIDS and food security. In particular the Representative of the FAO highlighted the organisations guidelines on incorporating HIV/AIDS into emergencies. She suggested that the meeting identify HIV/AIDS as an emergency requiring an emergency response.
The representative from the SADC Health Sector Coordinating Unit pointed out that in order to obtain greater political commitment it was important for packaged information to be provided to politicians so as to develop their understanding of the issues. In a similar vein the UNAIDS CPA in Zambia called for programmes targeting the media on HIV/AIDS and the humanitarian crisis. The Representative from the WHO requested that the meeting expand the scope of its understanding on the assessment of the situation and look at vulnerability in the broadest sense of the word. The UNAIDS Country Programme Adviser (CPA) for Swaziland highlighted the need to address the food and nutritional needs of PLHAs. The Representative from UNAIDS Inter-country Team of West and Central Africa called for the meeting to consider ways in which rural people could be empowered so that they can take care of their needs independently. The representative from the UNFPA Country Support Team in Harare requested that attention be given to communities that do not have resources, and that local efforts are strengthened in responding to HIV/AIDS and the humanitarian crisis rather than being undermined.
|
