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I have come very, very late to this debate (i.e. today!) and have been
trawling the discussions on growth and poverty and risk and vulnerability
for the last few hours. I may have missed it somewhere (in which case,
please correct me) but I am surprised to see virtually no mention of the
implications of HIV/AIDS for growth, poverty, risk, vulnerability, and the
type of strategic adjustments that may need to be made in response. Looking
at the background papers, there is this in the August 2002 paper:
"Mitigating the effects of HIV/AIDS must be a major focus of attention"
(p24)....and:
"Supporting governments to implement HIV/AIDS mitigation strategies that
take account of agriculture, and agricultural and rural poverty strategies
that take full account of HIV/AIDS." (p27)
Why has there been no debate on this?
Is it because it is not considered important, not important for agriculture,
or not important for DFID?
In recent years, as the causes and consequences of HIV epidemics have become
clearer, so has the fundamental importance of agriculture. Agriculture is
the main source of livelihood for the majority of people globally affected
by HIV/AIDS, and agriculture as a sector is particularly threatened by the
pandemic, given the implications of reduced labor power for the ability of
affected households to ensure food security - and given the rapid rate of
attrition of agricultural extension capacity. A plethora of studies on this
have emerged. Many have employed a DFID-pioneered sustainable livelihoods
approach to structure their investigations, and many have found significant
impacts on all the major classes of asset or capital, and on most
institutions.
The DFID paper speaks of mitigation, which clearly is a priority. But
agriculture as a source of livelihood may also reduce risk, through reducing
exposure to the virus. The determinants of these risks may be driven by
household poverty forcing displacement, migration -- or at an extreme,
transactional sex -- and/or driven by an individual's state of malnutrition
which increases infection risk. If such food and nutrition insecurity can be
addressed through an HIV-responsive agricultural strategy, this may be one
important pillar of broad-based prevention, as well as mitigation. It may
indirectly also be important for care (we know that an individual's energy
requirement rises by 10-30% following HIV infection) and for treatment (we
are learning more about the crucial importance of good nutrition for the
acceptability, efficacy and safety of antiretroviral therapy).
When it comes to actions that combat the HIV/AIDS-hunger nexus, the
empirical base is still thin. Where agricultural organizations have launched
actions that address HIV/AIDS-food security links, they have rarely been
monitored. Clear operational hypotheses and indicators are seldom stated and
followed up on, and "best practices" are announced but rarely properly
evaluated.
DFID has a major advantage in its use livelihoods orientation and could
build on this to help develop appropriate "HIV lenses" to apply in different
contexts to agricultural policy -- and to other policies affecting risk,
vulnerability and livelihood security. Perhaps one reason why this has not
been discussed is because it is so fundamentally cross-cutting. Bridges need
to be built between social scientists, epidemiologists, public health
specialists, nutritionists and agricultural economists to fully map the
interactions and to look at ways improving the HIV literacy of ag policy.
Again, a livelihoods approach would facilitate this.
Stuart Gillespie, PhD
Senior Research Fellow
International Food Policy Research Institute (IFPRI)
2033 K Street, NW,
Washington DC 20006-1002, USA
202-862-5638 (tel) 202-467-4439 (fax)
www.ifpri.org
www.isnar.org/renewal
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