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HIV/AIDS and food security in Africa

A report for DFID

Alex de Waal and Joseph Tumushabe

1 February 2003

Posted with permission of DFID (Pretoria)
[Complete document - 284Kb ~ 2 min (22 pages)]     [ Share with a friend  ]

Introduction

  1. This paper summarises existing evidence and experience concerning HIV/AIDS and food security in Africa. It deals with two major issues, namely (a) the impact of HIV/AIDS on agrarian livelihoods and how this can be mitigated and (b) the implications of a concurrent generalised HIV/AIDS epidemic and an episode of acute food insecurity, what is termed 'new variant famine'.


  2. Concerning HIV/AIDS and agrarian livelihoods, there is plentiful evidence, principally drawn from small-scale studies in eastern, central and southern Africa, dating back to the late 1980s (FAO 2002, FEG 2002, Haddad and Gillespie 2000, Barnett and Whiteside 2002). There is also a handful of significant 'success stories', notably from Uganda, which indicate the possibility of successfully mitigating the impacts of the epidemic on livelihoods (see Appendix A). However, despite the best efforts of the FAO, these insights and policy implications have yet to be adopted systematically by ministries of agriculture and major donors, and where they have been adopted, they have yet to be taken to scale.


  3. Concerning HIV/AIDS and acute food insecurity and famine, there is a severe dearth of systematic information, although there are plausible hypotheses backed by informed observation that are consistent with the modest statistical data and micro studies available. The 'new variant famine' hypothesis of the first author of this paper has, since November 2002, become the leading 'alternative' paradigm for understanding this crisis, adopted by (among others), the heads of UNICEF and WFP and the UN Secretary General's Special Representative for AIDS in Africa in their advocacy messages. In the light of the current food crisis afflicting southern Africa, there is a pressing need to develop and refine this hypothesis, and develop policy tools and practical responses, both to meet the immediate demands of mitigating the current crisis, and to respond to its medium- and long-term implications. It is possible that the current crisis will escalate to a calamity on a scale not before seen in SSA.


  4. Two pervasive themes are also addressed in this paper: why the HIV/AIDS epidemic is a distinct shock unlike others (so that we are 'not coping but struggling'), and why the issue has been neglected. It concludes with some scenarios for the future.


  5. The International Fund for Agricultural Development (IFAD) describes household food security as 'the capacity of households to procure a stable and sustainable basket of adequate food' (IFAD, 1996). It incorporates (a) measures to enhance and stabilise household access to and availability of food across seasons and transitory shortages; (b) activities that would sustain food supply in the long term; and (c) constant attention to the adequacy of food while complying with nutrient and safety requirements and cultural preferences. Households are said to be food-secure when food availability, equal access to food, stability of food supplies, and quality of food are in balance with each other. For rural households, the equitable availability of stable quantities of nutritious food depends on food production (using mainly family labor, land, and other resources); food purchase (using household income); assets that can be quickly turned into food or cash as necessary; and social claims on others through custom and societal structures such as family and community networks.


  6. All aspects of this are affected by both the household-level impact of HIV and AIDS and the wider impacts of a generalised HIV/AIDS epidemic. As adult life expectancy in SSA drops to 25 or 20 years, or in some cases even less, our models for food security need dramatic revision. The basic assumptions built into economic and development analysis, farming systems research, livelihoods studies, and coping strategies research, that a household can command basic food entitlements in 'normal' times, needs to be questioned. Equilibrium models, in economics, demography and other branches of social and economic science, may no longer be valid.


  7. Recent estimates by the UNAIDS indicate that 28.5 million adults and children live with HIV/AIDS in Africa, with some 2.2 million Africans having died of AIDS in 2001 alone (UNAIDS, 2002) surpassing any other cause of death on the continent. At least 10% of those aged 15-49 are infected in 12 African countries. The epidemic is spreading at a hitherto unimaginable rate in southern Africa. There is no indication of a ceiling on HIV prevalence rates. Despite some notable declines in prevalence rates in Uganda and parts of Zambia, and low rates in Senegal, the effects of the epidemic and associated mortality are going to remain for generations. According to UNAIDS estimates, assuming that prevention, treatment and care programmes will have a modest effect on the growth and impact of the epidemic in the next two decades, it is projected that, between 2000 and 2020, 55 million Africans will die earlier than they would have in the absence of AIDS (UNAIDS 2002). The worst is yet to come. The next decade will see a major onslaught on the foundations of African societies with the possibility of development and governance processes thrown into reverse (de Waal 2003).


  8. Evidence suggests that the HIV epidemic is disproportionately affecting agriculture relative to other sectors (IFAD 2001). This is not because rates of HIV are higher among workers in the agricultural sector than elsewhere (indeed they are usually lower), but because the structure of the agricultural sector, especially the smallholder subsector, is such that it is much less able to absorb the impacts of the human resource losses associated with the pandemic. Moreover this impact on agriculture, is likely to be far reaching as over 70% of the population depend on the sector for livelihood. In agrarian societies, the HIV/AIDS epidemic is intensifying existing labour bottlenecks, increasing widespread malnutrition; proving a barrier to traditional mechanisms of support during calamities, massively adding to the problems of rural women, especially female-headed farm households arising from gender division of labour and land rights/resources, and deepening macroeconomic crises by reducing agricultural exports. In extremis, it is creating the 'new variant famine.'


  9. Among the reasons why HIV/AIDS has this severe impact are the pre-existing fragility of most African farming systems, the distortions built into international markets in agricultural produce, and the role of the agrarian sector in most African countries as an unacknowledged social safety net. Under the strain of the HIV/AIDS epidemic, the more vulnerable farming systems are simply breaking down, threatening a social calamity on a scale not witnessed before in the continent.


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