Food and Nutrition Security

(source NACO 2004)

The HIV AIDS Pandemic is a global crisis with impacts that will be felt for decades to come. More than 20 million have succumbed to HIV AIDS since the first reported case in 1981.

In India, the epidemic is considered to be generalized in at least six States, Andhra Pradesh, Karnataka, Maharashtra, Manipur, Nagaland and Tamil Nadu with prevalence levels surpassing 1%.

HIV is a long wave crisis but this is often not realized. The first wave is HIV infection, followed by  a wave of Opportunistic Infections (OIs), the most common being Tuberculosis, the third wave being AIDS  and death followed by a wave of impacts on the household, community and national level. The impact on households, community and the nation are evident in sub Saharan Africa.

Mr James Morris, Executive Director, United Nations World Food Programme in his keynote address  at a seminar in Delhi in 2004 said that in sub Saharan Africa seven million people in agriculture lost their lives to HIV/AIDs, fourteen million children were orphaned and the UN expected a million children being orphaned per year for the next six years and given the ‘demographic, there is nothing that can be done.’

HIV/AIDS is most extraordinary health dilemma ever known and has affected every single dimension of life in sub Saharan Africa. Life expectancy in these areas has decreased by 22 years! In sub Saharan Africa , by 2004 seven million people, in agriculture, had lost their lives to HIV which at that time was more than the entire population of people working in agriculture in North America and Western Europe.

We should all learn from the Africa experience and start taking precautionary measures.

 

FOOD AND NUTRITION

For the poorest person living with HIV and AIDS Food is the highest priority. HIV exacerbates malnutrition, increases fatigue and reduces work productivity. These factors

in turn, directly affect a person’s ability to provide enough food for themselves and their families. The role of food as a defence against HIV cannot be over estimated.

Good nutrition makes a huge difference in the lives of HIV infected people. They stay healthy and are better equipped to fight OIs. TB is the most common OI and this like HIV aggravates the effects of malnutrition.

 

WOMEN

Women are the face of HIV because women are biologically more susceptible to HIV. Male- to- female transmission is two to four times more efficient than female- to- male. Women’s  economic dependence on men, their unequal access to resources, opportunities, assets and treatment, place them in the high risk category.

Better maternal nutrition clearly benefits both the mother and the child.

MATERNAL NUTRITIONAL STATUS AND VERTICAL TRANSMISSION (Mother to child).

• A mother’s nutritional status is directly and strongly related to her immune status, which in turn is directly related to birth weight and the nutritional status of the infant. This fact has not changed since the pre HIV era.
• Better nutritional status of  an HIV Infected mother reduces the chances of vertical transmission from mother to fetus.
• 7 per cent vertical transmission takes place during pregnancy, 15 per cent during delivery and 15  per cent during the first two years of breast feeding.
• While to reduce the risk of vertical transmission during pregnancy the nutrition status of the mother is of the utmost importance,  medication given during the  seventh month of pregnancy and at the time of delivery further reduces vertical transmission.
• Women are counseled about breast feeding and it has been found that while some women may opt for top feeds or replacement feeding because it is affordable, in a resource crunch setting exclusive breast feeding is recommended in the first six months of life. The infant, then, must be taken off breast feeding.

PROTECTING ORPHANS AND VULNERABLE CHILDREN 

In absolute numbers Asia has the highest number of orphans in the world. Besides orphans, there are millions of more vulnerable children who are caring for infected and ill parents, dropping out of school because of financial constraints, hungry and under nourished children.

The link between education, food security and nutrition is very significant.

Interventions need to be multi facetted:

• Strengthen the capacity of families to protect and care for orphans and vulnerable children by prolonging the lives of parents and providing economic, psychosocial and other support.
• Mobilize and support community based responses,
• Ensure access for OVCs to essential services  like  food security, education, health care, birth registration, legal rights, vocational training and employment
• Raise awareness at all levels to create a supportive environment  for children and families affected by HIV.

Given the enormity of the problem and devastation caused by HIV these issues need to taken very seriously.