Hungry HIV-positive patients abandon their ARV treatment as food prices rise
ALTHOUGH THERE have been great improvements in treatment and care for people living with HIV in many countries, death due to HIV and Aids-related illness in the world’s poorest countries remains unjustifiably high.
A major contributing factor is that more than 800 million people are chronically undernourished globally, and the HIV epidemic largely overlaps with populations already experiencing poor access to food and adequate nutrition.
A 2006 Hunger Map superimposed over the UNAIDS 2006 HIV and Aids map showed significant correlation between hunger and HIV. Controlling for the variation in gross national income per capita, the Global Hunger Index is 3.9 points higher in countries with HIV.
The 2006 Political Declaration on HIV and Aids – unanimously adopted by 192 member states in New York – committed to integrating food and nutritional support into the responses to HIV and Aids (Article 28), yet there is a stark gap between the 2006 commitment and delivery at the end of 2009.
As we mark World Aids Day, more than 5,700 people still die from Aids-related illness every day and there are 25,000 deaths daily from hunger-related causes. With effective interventions, both hunger and HIV are very preventable public health problems.
The sharp increase in food prices over the past two years has raised serious concerns about the food and nutrition situation of poor people, and especially the poorest, living with HIV and Aids in developing countries.
Hungry HIV-positive patients are abandoning their ARV treatment in Uganda, Kenya and Ethiopia as food prices rise. This carries the risk of drug resistance later.
In southern Africa, known as the HIV hyperendemic region, increasing hunger is fuelling the interruption of treatment and increased risk-taking by women desperate to feed their children.
Food insufficiency has been associated with high-risk sexual behaviour among women in Botswana, Swaziland, Malawi, Zambia and Tanzania.
Aids in a time of hunger poses additional challenges for infected and affected people. Adults with HIV infection require 10 per cent more energy and, as the disease progresses, that need increases to between 20and 50 per cent.
As food prices rise, less nutritious foods are consumed. For people who are already sick, this can have detrimental health effects. The poorest families are being forced to choose between food for the household and ARVs for loved ones.
Timely delivery on the 2006 Declaration is being compromised by the global food, fuel and international financial crises, yet food is still the first medicine and lives depend on it.
Programming of livelihood interventions that take into account issues of poverty, gender inequality, food insecurity and nutrition at household level are essential in the response to HIV and Aids.
- Breda Gahan is global HIV and Aids programme adviser with Concern Worldwide
