Africa: Food Security, HIV/AIDS Treatment Closely Linked

Africa's struggle to contain HIV must include strategies to ensure that its people have enough to eat, said experts who met recently in Cape Town, South Africa, to discuss food security.

The early years of the HIV epidemic claimed farmers in the already-marginal, agriculture-based economies of Africa, noted Stuart Gillespie, director of a non-governmental organization (NGO) promoting food security. Today, successful antiretroviral therapy still can be compromised from the lack of adequate nutrition.

Food crises "can impact treatment, the ability of people to remain on drugs when they're too hungry, when they cannot afford to buy food to meet the increased appetite they have [when] on the drugs," said Gillespie, director of the Regional Network on AIDS, Livelihoods and Food Security, an NGO with hubs in southern African countries.

When people on treatment are unable to find adequate nutrition -- and antiretroviral therapy demands about 30 percent more calories than usual -- their condition can quickly deteriorate, Gillespie said.

"If people are stopping drugs because they are too hungry to take the drugs without feeling completely sick, if they're stopping the drugs and compliance levels drop below 90 percent, we're in a situation where the virus becomes resistant to the drugs. And therefore, we need second-line therapies or third-line therapies, which are going to be a lot more expensive and even more difficult to resource in the current climate of austerity," Gillespie said.

Civil servants with responsibility for disseminating agricultural expertise to African farmers also were felled by the epidemic, Gillespie noted.

"During a five-year period between 2002 and 2007 in both Malawi and Zambia, one in eight agricultural extension workers had actually died of HIV," he said. "Farmers were therefore not able to avail themselves to new technologies."

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