Inter Press Service - July 5, 2002
Lewis Machipisa

Malnutrition is one of the major clinical manifestations of HIV infection.

Over the past few weeks, Rudo Kwaramba of World Vision, a Christian non-governmental organisation, has seen a sharp increase in moderately malnourished children due to HIV/AIDS in parts of southern Zimbabwe where her organisation is handing out relief food.

"We have realised that the food shortage is now exacerbating their downward spiral," says Kwaramba.

"Good nutrition is one way of prolonging people's health whether one is infected with HIV or not. But if there is no food and you are infected, you become more vulnerable," she says.

According to Kwaramba, food insecurity further increases both the risks of being exposed to HIV and a household's vulnerability to its increasing impact as the disease progresses.

"So for Zimbabwe, it's particularly worse when you realise that we have one of the highest rates of infection and also the worst hit by the drought in the region," she says.

More than 28.5 million people are living with HIV/AIDS in sub-Saharan Africa, according to the latest Joint United Nations Programme on HIV/AIDS (UNAIDS) report.

Six of the seven countries - except South Africa now with prevalence rates higher than 20 percent - Botswana (38.8 percent), Lesotho (31 percent), Namibia (22.5), South Africa (20.1), Swaziland (33.4), Zambia (21.5) and Zimbabwe with 33.7 percent, are facing devastating drought.

Swaziland has the second highest prevalence HIV/AIDS infection rate in the world after Botswana.

Elizabeth Lwanga, the UN Development Programme (UNDP) Resident Representative for Swaziland, says about 34 percent of women sampled at ante-natal care showed that they were infected. "Although the official rate is 25 percent it could be much higher," she says.

"Right now our fears are to what extent is the hunger going to accelerate the AIDS situation. Many people will develop AIDS so much faster than they would have because if they are infected and they do not have proper nutrition they will really become badly affected," says Lwanga.

She says there is a need to examine the link between HIV/AIDS and food insecurity.

"This is something that all people, all agencies really need to look out for and also the need to have a food package that includes a concern for nutrition for all people and not only for those who are infected with HIV."

"I believe most of the people infected with HIV don't know that they are infected. So it's important to make sure that there is adequate nutrition for all in the country," she says.

For a person suffering from HIV/AIDS, not having the right nutrition could be a recipe to fast death.

The unfolding food shortage in Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe has increased the vulnerability of millions of people to HIV. At the same time, the personal, household and community impacts of HIV/AIDS are already fanning the flames of food insecurity.

While millions go hungry each night, the high HIV/AIDS infection is making the food crisis worse.

According to a recent Food and Agriculture Organisation (FAO) report, HIV/AIDS has hit the region's farm sector hard, with stricken families struggling to produce enough food to survive.

"The disease is no longer a health problem alone, but is having a measurable impact on food production, household food security and rural people's ability to make a living," the report said.

A now widely circulated quote from Asia goes, "there is no one to till the fields as all the people have gone to bury a relative who has died of AIDS".

Female-headed households are the most vulnerable. Women who have their own children would have the added burden of looking after the children of dead relatives and friends.

According to a declaration of commitment to be reached by 2003, made last June by the United Nations General Assembly Special Session on HIV/AIDS, the inclusion of nutrition as a core part of any HIV-care package is essential.

The session noted that the current focus on increasing access to anti-retroviral drugs in low and middle-income countries should not obscure the fact that, for much of the world's population living with HIV, the need for food remains an overwhelming priority.

"Nutrition and AIDS operate in tandem. Nutritional deficits make people with HIV more susceptible to disease and infections of all sorts. And malnutrition is one of the major clinical manifestations of HIV infection.

A UNAIDS study in Zambia revealed the toll of HIV/AIDS on households can be very severe. In many cases, the presence of AIDS means that the households will dissolve. In Zambia, it was shown that 65 percent of households in which the mother had died had dissolved.

But much happens to a family before this dissolution occurs; HIV/AIDS strips the family of assets and income-earners.

Research in Tanzania has shown that individuals food consumption dropped by 15 percent in the poorest households after the death of an adult.(END/IPS/AF/HE/HR/LM/MN/02)
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