To fully realize the potential of food aid to reduce risk and to mitigate the impacts of HIV/AIDS, existing strategies and interventiuons need to be re-viewed using an HIV/AIDS lens.HIV/AIDS ,Human capital ,

Gillespie, Stuart

Kadiyala, Suneetha

English

Research Papers in Economics

STRENGTHENING FOOD ASSISTANCE AND FOOD POLICY RESEARCH
Linking Research and Action
H
IV/AIDS is a long-wave global
crisis with impacts that will be
felt for decades to come. Nearly 30
million people in Sub-Saharan
Africa—over 70 percent of the glob-
al total—are infected with the virus.
Whatever the impact of the planned
roll-out of antiretroviral therapy,
AIDS-related morbidity and mortali-
ty will continue to increase for years
to come—and with it, the risks of
chronic or acute food insecurity for
millions.
Insights from IFPRI Research
HIV/AIDS, nutrition, and food
insecurity are becoming increasing-
ly entwined in a vicious cycle—
HIV/AIDS is heightening vulnera-
bility to food insecurity, which in
turn may heighten susceptibility to
HIV infection. The interaction
between nutrition and HIV/AIDS is
driven by complex physiological
dynamics that are mutually rein-
forcing and destructive.
Food aid has significant potential
for breaking this cycle—not only
through mitigating AIDS impacts
on food security, but also through
reducing the susceptibility of people
to the HIV virus. The latter may be
achieved where food aid prevents
people from adopting risky liveli-
hood strategies to feed themselves.
Transactional sex is one extreme
example of this; migration is anoth-
er. Food aid can also contribute to
improving the dietary intake of per-
sons living with HIV/AIDS
(PLWHA) and those most affected
by the disease facilitating a greater
productive and caring capacity.
In order to highlight and ulti-
mately realize this potential, an
“HIV/AIDS lens” is proposed as
one tool to facilitate the rethinking
of current programmes in the con-
text of HIV/AIDS (see reference
cited at bottom of brief). The lens is
bifocal in revealing both HIV-relat-
ed susceptibility and AIDS-related
vulnerabilities. It is dynamic, evolv-
ing, and will be refined as knowl-
edge of what is happening is
updated. Using and refining the lens
is an iterative learning-by-doing
process.
Implications for Food
Assistance Programming
In order to ensure that food assis-
tance of all types remains relevant
and appropriate in the context of
high HIV-prevalence rates, food aid
organizations must review their
mission, vision, objectives, time-
lines, and capacities, taking into
account these new realities.
HIV/AIDS needs to be main-
streamed into strategic planning and
day-to-day operations. Applying an
HIV/AIDS lens to existing food
assistance programmes in eastern
and southern Africa points to the
need to rethink both strategy and
modality of intervention. Some
examples of possible modifications
are given in the table below.
New design features include
those aimed at sensitizing current
activities to the high prevalence
environment and its impact on com-
munities, and those that are specifi-
cally focused at addressing the
impact of the disease on infected
and affected individuals. It is
increasingly recognized that opera-
tional modalities may have serious
implications for the inclusion and
exclusion of PLWHA and affected
households. Key issues include the
distance and frequency of food dis-
tribution (and/or the services to
which food is attached), weight and
packaging of food rations, and sen-
sitivities around enrolment and
“discharge” criteria. The role of
food aid in the identified program-
matic modalities, as well as the size
and composition of the food basket,
need to be carefully considered in
terms of strengthening a variety of
services and their attendance/com-
pliance versus improved food secu-
rity and nutritional well-being.
To fully realize the
potential of food aid to
reduce risk and to mitigate
the impacts of HIV/AIDS,
existing strategies and
interventions need to be
re-viewed using an
HIV/AIDS lens.
INTERNATIONAL FOOD
POLICY RESEARCH INSTITUTE
sustainable options for ending hunger and poverty
IFPRI
®
Rethinking Food Aid to Fight AIDSSuneetha Kadiyala and Stuart Gillespie (2003) “Rethinking Food Aid to Fight HIV/AIDS,” Food Consumption and
Nutrition Division Discussion Paper 159, International Food Policy Research Institute, Washington, D.C. Contact
author at s.gillespie@cgiar.org.
INSTITUTIONAL CONTACTS:
Food Consumption & Nutrition Division, International Food Policy Research
Institute (www.ifpri.org), 2033 K St., NW, Washington, DC 20006-1002 USA, 
Tel: +1-202-862-5600, Fax: +1-202-467-4439 Email: IFPRI-FCN@cgiar.org
World Food Programme (www.wfp.org), 68/70 via Cesare Giulio Viola,
Parco dei Medici, I-00148 Rome, Italy, Tel: +39-06-65132628,
Fax: +39-06-65132840 Email: Allan.Jury@wfp.org
This IFPRI/WFP brief is based on preliminary research results. Copyright © 2004 International Food Policy Research Institute and World Food Programme. All
rights reserved. Sections of this document may be reproduced without the express permission of, but with acknowledgment to, IFPRI and WFP.
What difference does HIV/AIDS make to food aid programming
Type Modality Design features in non-HIV context Design features in heavy HIV/AIDS context
Livelihood
support
Human
capital
develop-
ment
Emergency
relief
I
n
c
o
m
e
 
g
e
n
e
r
a
i
t
o
n
 
a
n
d
m
i
c
r
o
c
r
e
d
i
t
Mostly targeted to women's groups
Difficult in reaching ultra poor
Could be targeted to PLWHA associations, orphans and vul-
nerable children (OVCs), and other vulnerable groups such as
elderly-headed households and households taking in foster
children.
Lack of trust regarding repayment in group-based lending in
high HIV-prevalent regions; greater stigma and social exclu-
sion.
F
o
o
d
-
f
o
r
-
a
s
s
e
t
s
/
w
o
r
k Based on the premise of labour avail-
ability and self targeting
Labour-intensive works
Labour may not be abundant and self-targeting may not work
for PLWHAs or child- and elderly-headed, labour-short house-
holds who are often least able to undertake manual work. The
participant/beneficiary dynamics requires rethinking.
Dissemination of labour-saving technologies, promotion of
labour and tool banks. Crop diversification with an emphasis
on labour-extensive and nutrient rich crops. High input/output
ratio activities such as conservation farming.
F
o
o
d
-
f
o
r
-
t
r
a
i
n
i
n
g Often focused on volunteer training,
mostly health and extension workers,
and vocational/agricultural skills train-
ing
Should be continued, but expanded to traditional birth atten-
dants, home-based care (HBC), and community-based child-
care centre volunteers; volunteer teachers in informal schools
and for teachers to be trained in HIV/AIDS-related issues.
Activities should also consider alternative, realistic livelihood
opportunities for youth.
F
o
o
d
-
f
o
r
-
e
d
u
c
a
t
i
o
n One of the most popular food aid
interventions, targeting mostly schools
in chronically food-insecure regions
Take-home ration given to girls
Targeting of schools to take into consideration food-insecure
communities in high HIV/AIDS prevalence areas.
Take-home ration to be provided based on vulnerability crite-
ria, including OVC status. Involvement of the community is
crucial to prevent stigma of OVCs.
F
o
o
d
-
f
o
r
-
h
e
a
l
t
h
Supplementary feeding of young chil-
dren (<5) and pregnant and lactating
women
No attention paid to adult illness
Programmes to consider malnutrition risk factors related to
HIV/AIDS-affected care environment as well as HIV infection
(i.e., criteria for prevention of mother-to-child transmission
[PMTCT] admission, or supplementary feeding).
Identification and design of nutrition support activities for
chronically ill through home-based care, TB and ARV treat-
ment, etc.
F
o
o
d
-
f
o
r
-
l
i
f
e
 
(
e
m
e
r
g
e
n
c
y
 
r
e
s
p
o
n
s
e
) Often limited to distribution of relief
food
Characterized by quantitative food
response
No special attention to youth
Little attention paid to lives and liveli-
hoods of refugee host communities
Need for structural response to build capacity and livelihoods
to prevent survival sex and exploitative power relations.
Need to strengthen the nutritional validity of the response with
special care for vulnerable groups.
Crucial to contain the epidemic. Strategies to be devised to
assist youth in negotiating safe sexual practices and livelihood
approaches.
Exploitation of refugees by host population and vice versa.
Investments in improving livelihoods and HIV-related educa-
tion to include refugees and host communities.
Source: Adapted from Kadiyala and Gillespie 2003.

Rethinking food aid to fight AIDS

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