Programs that provide access to no-cost antiretroviral drugs have had a significant impact on people living with HIV/AIDS, but they also should take into account the effects of poverty and hunger, according to a report recently released by the Catholic Agency for Overseas Development, PlusNews reports. According to CAFOD, the "long-term sustainability" of people living with HIV/AIDS who need treatment is "threatened by the continuing lack of food and economic independence."

The report, which includes interviews with several organizations, found challenges in two aspects of sustainability: the need and desire of clients of antiretroviral programs to become self-reliant, and the programs' need for clients to become self-reliant for the programs' own sustainability. Jo Maher, author of the CAFOD report, said that antiretroviral programs "need to take into account the fact that people on treatment still need to eat and still need an income." He added that programs providing antiretrovirals should determine what form the income should take based on individual capacities. "HIV-specific organizations, for instance, should decide whether to retain their HIV focus and partner with organizations with better skills in income generation, or expand their activities to include income generation," Maher said, adding, "Sometimes they may not have the skills or manpower to take on the task themselves."

James Kamau, coordinator of the Kenya Treatment Access Movement, said antiretroviral programs need to include food as part of their support to HIV-positive people. Most antiretroviral programs "started with the basic aim of keeping people alive, but drugs alone cannot keep [an HIV-positive person] alive," Kamau said, adding, "If you don't feed people, they can't regain enough strength to work and earn a living." Kamau noted that in Kenya, poverty is a "huge problem." He added, "Women in particular suffer because they are responsible for caring for and feeding people in the home, and when they have no means to do this the whole household suffers." Kamau said that although antiretroviral programs need to provide food as part of a complete treatment program, they should not provide income-generating projects. "Those who get better should be able to find work for themselves, and if they fail, it is the responsibility of the government to look after their needs," Kamau said, adding, "If the government spent a decent amount of the national budget on health, people would get their drugs and would be well enough to work, thereby improving the economy and creating enough work for everyone" (PlusNews, 7/18).

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