USAID Programs: HIV/AIDS and Nutrition
The U.S. Agency for International
Development is committed to reducing the impact of HIV/AIDS
on individuals, families, and communities in the developing
world. Most of the world’s 40 million people currently
living with HIV/AIDS reside in communities already suffering
from poverty and malnutrition. Good nutrition with a well
balanced and adequate diet, sometimes including food assistance,
can play an important role in decreasing risk behaviors that
can expose an individual to HIV/AIDS, providing care and
support to those it affects, and mitigating its impact on
these communities.
The Relationship Between Nutrition, Food Security, and HIV/AIDS
HIV/AIDS has significant nutrition-related
implications and consequences for individuals, families,
and communities. In infected individuals, HIV contributes
to and is affected by nutritional status. Consequences of
HIV infection include inability to absorb nutrients from
food, changes in metabolism, and reductions in food intake
due to HIV-related symptoms. In turn, poor nutrition increases
the vulnerability to, and the severity of, opportunistic
infections. Poor nutrition can also reduce medication efficacy
and adherence, and can accelerate the progression of disease.
HIV/AIDS creates significant economic stress on households
and communities that affects both nutritional status and
long-term food security, the physical, social and economic
access to sufficient food for a healthy and productive life.
The Food and Agriculture Organization has estimated that
since 1985, in the 27 most affected countries, over 7 million
farmers have died of AIDS. Households lose not only the
income and food production of sick individuals but also
the economic contributions of family members who care for
them. Additional losses include future income potential
among orphans who cannot afford an education, and the interruption
of the transfer of agricultural skills from one generation
to the next.
Illness and
death bring substantial expenses – including
medical care, funerals, and care and
education of orphaned children – that
take resources away from household food
budgets. Research in Tanzania found a
15 percent decrease in per capita food
consumption in the poorest households,
following the death of an adult. Recent
research in Kenya showed a 68 percent
decline in food production following
the death of a male household head.
The Role of Food and Nutrition Assistance
Food and nutrition programs can assist
in mitigating the effects of HIV/AIDS at the individual,
household, and community levels, helping infected individuals
remain productive and allowing families and communities to
better cope with the economic losses associated with HIV/AIDS.
Objectives of food and nutrition assistance include:
- Using food aid to improve the nutritional status of individuals affected by HIV/AIDS to increase the quality and duration of life, and to keep children affected by HIV/AIDS in school.
- Increasing overall food security in infected or affected households
- Improving knowledge and promoting practices on the nutritional requirements of people living with HIV/AIDS
- Involving communities in providing care and support to vulnerable households
In addition to food aid, food and nutrition programs often
provide HIV/AIDS prevention and care services such as counseling
and home-based care. They can also raise awareness of HIV/AIDS
and mobilize community support for HIV/AIDS programs. Agriculture
and other multi-sectoral activities may also preserve and/or
increase household assets, strengthen resilience, and ensure
food security.
As programs integrate anti-retroviral therapy, there will be an increasing need for nutritional inputs. A number of medications require that they be taken along with food, and there is some evidence that the full benefit of the therapy may not be achieved in malnourished individuals, in particular pregnant and lactating women. USAID Programs
In response to the growing need for food and nutrition assistance in HIV/AIDS programs, USAID reviewed the relationship between food, nutrition, and HIV/AIDS to identify the best means to utilize food aid programs to help mitigate the impact of HIV/AIDS. For example, a recent study found that, compared with an average adult, a person with HIV requires 10 to 15 percent more energy and 50 to 100 percent more protein a day. Such findings will be integral to the development of future nutrition and HIV/AIDS activities.
USAID is currently responding to the nutritional needs of affected households and communities in a number of countries. Non-governmental and faith-based organizations are key partners in the implementation of these food assistance and HIV/AIDS programs. Illustrative activities include:
Rwanda: USAID is working to ensure improved food security for Rwanda’s most vulnerable children. Non-governmental organizations provide food to approximately 29,000 children affected by HIV/AIDS as part of a comprehensive package of services that also includes HIV/AIDS education, counseling, home-based care, vocational training, payment of school fees, and assistance to help households earn more income. Food assistance is expected to improve the ability of households to care for children affected by HIV/AIDS.
Uganda: USAID is using food aid to help meet the nutritional needs of children and families affected by HIV/AIDS. This five-year, $30 million program is the largest of its kind in the world. The program targets approximately 60,000 individuals who have HIV/AIDS or live in households where providing HIV/AIDS care is undermining the ability to meet food and nutrition needs. The target population receives intensive nutrition education in addition to food aid. The program involves communities in food distribution in order to raise awareness, reduce stigma, and mobilize community involvement in HIV/AIDS activities.
USAID is planning similar programs in additional countries and will continue to expand its assistance using its considerable experience in food and nutrition programs.
February 2003
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