Hunger and HIV/AIDS are reinforcing each other in Southern Africa, "leading to a potentially tragic new level of famine", says a book published by a regional agricultural think-tank. The World Bank's annual report, released last week, also raises concerns over the pandemic's impact, pointing out that most people affected by HIV and AIDS depend on agriculture.

Food consumption has been found to drop by 40 percent in homes afflicted by HIV/AIDS, according to the UN Food and Agriculture Organisation (FAO); globally, Southern Africa is the region most affected by the pandemic.

The situation has been exacerbated by severe drought in Lesotho, Swaziland, Zimbabwe and southern Mozambique this year, with significant production deficits and high staple food prices limiting market access for households that have already run out of food they have managed to grow themselves.

AIDS has killed around 7 million agricultural workers since 1985 in the 25 hardest-hit countries, mostly in east and southern Africa, where AIDS-related illnesses could kill 16 million more before 2020, and up to 26 percent of their agricultural labour force within two decades, said the FAO.

Often described as "new variant famine" or "HIV-induced famine", this form is radically different from traditional famines, said the book, Silent Hunger: Policy Options for Effective Responses to the Impact of HIV and AIDS on Agriculture and Food Security in the SADC Region.

"The paradox is that while the traditional drought-related famines kill dependents first (children and elderly), the HIV-related 'silent hunger' affects the most 'productive' family members first."

The book is based on a study commissioned by the Food, Agriculture and Natural Resources Policy Analysis Network (FANRPAN) on the impact of HIV and AIDS in the seven most affected countries in Southern Africa: Botswana, Lesotho, Namibia, South Africa, Swaziland, Zambia and Zimbabwe.

Alex de Waal, an activist and writer, and Alan Whiteside, director of the HIV/AIDS research division at the University of KwaZulu-Natal, in South Africa, were the first to outline the "new variant famine" concept.

The FANRPAN book is critical of regional governments' response to the "invisible famine", which they describe as "slow" and inadequate", and presents a case for prioritising social protection.

In one of the first comprehensive studies on the impact of the pandemic on agriculture in the region, the book has uncovered some startling facts: in Botswana, the majority - 81 percent of respondents - had three or more meals per day before they contracted HIV, but after they became ill this dropped to 49 percent.

Approximately two people-years of labour have been lost by the time one person dies of AIDS, due to their weakening and the time others spend giving care, said the book, citing various studies.

James Breen, an agronomist based in Southern Africa, said, "Forty percent of the population in some of the countries in the region live with the HIV/AIDS, and at least 70 [percent] to 80 percent of the region's population depend on subsistence agriculture.

"At the best of times, small-scale farmers can expect subsistence, but with impact of natural disasters or, worst of all, HIV/AIDS, they have to liquidate all their assets for treatment, and they have no access to safety nets."

Burden on women

The authors of Silent Hunger commented: "Due to cultural and social traditions, women bear the brunt of the epidemic, both in terms of providing care for people living with HIV and AIDS as well as being at risk for HIV infection." UNAIDS has estimated that 57 percent of people living HIV and AIDS in southern Africa are women.

Of the seven countries participating in the study, four - Botswana, Zimbabwe, South Africa and Namibia - reported that most rural households were led by women; the exceptions were Swaziland, Zambia and Lesotho.

In Swaziland, gender inequality and poverty have contributed to the HIV and AIDS epidemic. "The practice of polygamy increases the risk of women being infected. Women are also tasked with the responsibility of caring for the sick members of the household, which also increases the risk of getting infected," said De Waal and Whiteside.

"When the man falls sick, it is the responsibility of the wife to provide care and take on additional duties to support the family. However, when the wife becomes sick, it is traditionally the responsibility of other women (not the husband) to provide care."

The book quoted a woman small-scale farmer in Botswana as saying, "I have not ploughed for the past five years because of taking care of AIDS children, who eventually died. So not only have I lost my children, but I have no food or seeds to start production. The sad thing is that my small [live]stock also strayed while I was running from one health provider to the next in the hope of saving my children."

In Zimbabwe, the FANRPAN study found that, traditionally, women were dispossessed of their land or assets after the deaths of their husbands, and continuation of the practice means they are left with little or no assets.

Response

The World Development Report 2008: Agriculture for Development, the World Bank's first analysis of agriculture since 1982, pointed out that there was "tremendous scope" for agricultural policy to become more HIV-responsive, to the benefit of health as well as agricultural goals.

The Bank called for the promotion of labour-saving technologies and crops as one way of addressing labour losses resulting from AIDS-related mortality in agriculture. "But for poorer smallholder households, the main constraints on livelihoods may be land and cash rather than labour," it said.

"Cash transfers to help them hire labour, [provide] more secure land tenure for women, and expanded agricultural extension programmes to include women and orphans, could have a greater impact on welfare."

Marcela Villarreal, the FAO's focal point for HIV/AIDS, said the agency had managed to convince some countries to draw up policies to help affected small-scale farmers, and Zimbabwe and Tanzania have drawn up agriculture strategies with the pandemic in mind. The FAO has a programme on property rights for women in Malawi, which has brought some changes in land ownership laws.

"For years, FAO has been advocating labour-saving technologies, even before the AIDS crisis came about," said Villarreal. It has advocated the use of the matraca, a zero-tillage planter easily operated by an individual.

The UN agency has also rolled out Junior Farmer Field and Life Schools in 10 countries in southern and east Africa, where orphans and vulnerable children in the age group 12 to 17 years, who often head households, are taught about agricultural techniques, entrepreneurship and HIV/AIDS; in Mozambique the project has trained 1,000 young farmers in the past 3 years.

FANRPAN cites programmes like the Food Security Pack (FSP) in Zambia, which promotes crop diversification and farming methods that help restore soil fertility and productivity, and encourages the timely use of agricultural inputs, besides providing marketing assistance. FSP aims to reduce poverty among 200,000 vulnerable but viable small-scale farmers by improving household food security.

To overcome the lack of land and labour often facing HIV/AIDS-affected households, the Livelihoods Recovery through Agriculture Programme, implemented in
Lesotho in 2002 by CARE, a US-based charity, and the Ministry of Agriculture, promotes producing crops with high nutritional content on small plots of land close to the home.

"Of the participants, 53 percent reported that they had stabilised or increased their food production," the World Bank said of the initiative in its report.

Often the only sources of income for both HIV-affected and non-affected households in many countries of the region are government food parcels, pension grants, orphan/foster care grants and the child grant. Community initiatives such as locally based home-care groups also assist affected households with information, help in caregiving and counselling.

According to Lindiwe Majele Sibanda, the executive director of FANRPAN, southern Africa needs longitudinal household surveys that will track the impact of the pandemic on agriculture and food security. "We need trends analyses if we are to adequately inform policy development. Short term ad hoc studies are not giving a full picture of the pandemic’s impact".