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United Nations
United Nations - Nations Unies

Mission Report: Lesotho, Malawi, Zambia, and Zimbabwe
22–29 January 2003

Mr James T. Morris, Special Envoy of the Secretary-General for Humanitarian Needs in Southern Africa
Mr Stephen Lewis, Special Envoy of the Secretary-General for HIV/AIDS in Africa

Rome, 10 February 2003

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The world knows that HIV/AIDS is fatal. The world also knows that southern Africa, where some of the highest HIV prevalence rates are found, has suffered from serious food shortages affecting millions of impoverished people. But the world clearly does not yet realize the immediate and long -term implications of a crisis caused by the conjunction of HIV/AIDS with chronic poverty, erratic rainfall , problematic government policies and natural resource degradation, or the urgent need it signals for a profound shift in humanitarian and developmental strategies.

In the six countries1 currently suffering food shortages in southern Africa, the HIV/AIDS pandemic is endangering the lives and livelihoods of millions of people and unravelling the social fabric of society to the extent that the stability and security of the region as a whole is at risk. Only recently have the governments of some of the most affected countries in southern Africa begun to comprehend the crisis that is upon them – a reality that has driven some political leaders in the region to speak of the threat of extinction. It has taken the loud emergency of a severe food shortage affecting 15.1 million people to demonstrate to the United Nations and its partners the insidious potential of HIV/AIDS to undermine entire societies and nations and turn crises into catastrophes.

From 22 to 29 January 2003, the Special Envoy of the Secretary -General for Humanitarian Needs in Southern Africa, James Morris, was joined by the Special Envoy of the Secretary-General for HIV/AIDS in Africa, Stephen Lewis on a mission that visited four affected countries in southern Africa – Lesotho, Malawi, Zambia and Zimbabwe.2

Both Special Envoys had been to the region in the previous few months, and both recognized the need for an unusual joint effort to tackle this unprecedented crisis. The mission was made up of senior officials of the Food and Agriculture Organization (FAO), the Office for the Coordination of Humanitarian Affairs (OCHA), the Southern African Development Community (SADC), UNAIDS, the United Nations Development Programme (UNDP), UNICEF, the World Food Programme (WFP) and the World Health Organization (WHO) (see Annex VII). Dr Prega Ramsamy, Executive Secretary of the SADC, was also a member for part of the mission. The high -level representation and the diversity of the mission are evidence of the seriousness with which the various agencies are taking this situation.

In general, humanitarian organizations have responded quickly to the crisis in southern Africa, and donors have been generous with their support for these efforts to date. A famine has been averted. The majority of the response strategies and resources have concentrated on the immediate goals of saving lives with food assistance and stabilizing the nutritional situation, which have met with success. Starvation and death have been staved off, but vulnerability remains; the region is a long way from being able to say that it is no longer in crisis. The mission was struck in particular by how food shortages appear to aggravate the impacts of HIV/AIDS by accelerating the progress of the disease in HIV-positive individuals. Governments, United Nations agencies, regional bodies, non-governmental organizations (NGOs) and donors are still struggling to re - tool their responses to ensure that a region already weakened by chronic poverty, poor governance, natural disasters and the HIV/AIDS pandemic will be able to recover in the medium to long term.

Over and over again, mission members were confronted with the stark realities of the underlying AIDS crisis: child -headed households; grandmothers taking care of numerous orphans; dying teachers and extension workers; and the seemingly surreal statistics of declining life expectancy. Perhaps the most disturbing realization came with a better understanding of the impact that this crisis is having on the region’s women. It was evident to the mission that although the prevalence of HIV infection is highest among women and girls -- who also take on nearly all the responsibilities of caring for the sick and orphaned, in addition to their regular obligations such as providing food for their households -- very little is being done to reduce women’s risks, to protect them from sexual aggression and violence, to ease their burdens or to support their coping and caring efforts. The apparent lack of urgency, leadership, direction and responsibility in the response of the United Nations, national governments, and the international community to the pandemic’s effects on women and girls is deeply troubling . For example, the early adoption of mainstreaming approaches to gender within United Nations agencies, funds and programmes has made gender issues everyone’s concern but no one’s responsibility. Whereas gender policies and principles are widely discussed by the United Nations, governments and NGOs, the urgent actions flowing from those discussions must be implemented. So far, that does not appear to have happened.

The first mission of Special Envoy Morris in September 2002 concluded that the traditional response patterns for humanitarian emergencies or for development contexts are simply not adequate to address the crisis in southern Africa. It is time to transform this observation into action. An immediate, strongly led and broadly implemented joint effort to take action on gend er and HIV/ AIDS must be initiated without delay. The effort should feature leadership from the United Nations, the active engagement of governments and substantially increas ed support to civil -society organizations, including remarkable grassroots initiatives.

Food aid will be essential for some time to come, but it must be combined with radical agricultural strategies and labour-saving technologies that increase resilience to erratic rainfall, help to generate income, and re-stimulate local food production without adding extra burden on households that are affected by HIV/AIDS. Relevant actions in education, health, nutrition, water, hygiene, and sanitation-related interventions will also be necessary. The pandemic’s steady weakening of national governments and its erosion of their social services call for measures that go beyond building capacity; it is time to speak of capacity replacement and replenishment. The urgency of providing anti-retroviral drugs to extend life and hope is literally heightened every day with thousands of additional deaths from HIV/AIDS. Medicines for helping people cope with opportunistic infections and condoms for prevention of disease transmission must also be made available. Orphans and children from HIV/AIDS-affected households desperately need life skills, guidance, love and care. All of this needs to be done through a framework of assistance that will support women, who have been fittingly described by the Secretary-General as the “lifeline” of communities in Africa.

  1. Lesotho, Malawi, Swaziland, Zambia and Zimbabwe are within the United Nations consolidated appeal process (C AP), while the situation in Mozambique is noted in the CAP regional overview. The separate, though undeniably large, needs of Angola are covered under an individual United Nations mechanism.
  2. Mozambique and Swaziland were not visited during the mission due to time constraints.

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