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The World of HIV © Copyright 2006 SASI Group (University of Sheffield) and Mark Newman (University of Michigan).
The World of Income © Copyright 2006 SASI Group (University of Sheffield) and Mark Newman (University of Michigan).
HIV prevalence in Africa
Three coexisting/interacting crises Livelihood/food insecurity HIV & AIDS Malnutrition
Vulnerability   of Livelihood Systems to AIDS Vulnerable Groups - Orphans, Elderly and Youth Headed Households,  Effect on Institutions Community-based, Civil society, Market, State, Global Outcomes Nutrition, Food Security, Education, Community Cohesion, Income Effect on Assets Human, Financial, Social, Natural, Physical, Political Responses Individual, Household, Community Vulnerability to infection HIV Stigma and Discrimination
  HIV   AIDS upstream   downstream   Food insecurity    Malnutrition   mid-stream Three stages of vulnerability
  HIV   AIDS prevention   mitigation   Food insecurity    Malnutrition   care & treatment HIV strategies
 
  HIV   Food insecurity  Malnutrition   Upstream vulnerability
HIV and Income Poverty
HIV and Income Inequality
  HIV   Food insecurity    Malnutrition   Upstream vulnerability Poverty? Wealth? Food insecurity Mobility Gender inequalities Social cohesion Hope?
  HIV   AIDS     Mid-stream vulnerability
The Vicious Cycle of Malnutrition and HIV Insufficient dietary intake Malabsorption , diarrhea Altered metabolism and  nutrient storage Increased HIV  replication Hastened disease  progression Increased morbidity Increased oxidative  stress Immune suppression Nutritional  deficiencies Source: Semba and Tang, 1999
  HIV   AIDS     Mid-stream vulnerability ART access and adherence STIs (especially HSV-2) Malnutrition Food insecurity (time, resources for care)
  AIDS   Food insecurity    Malnutrition   Downstream vulnerability
Impacts of HIV and AIDS on agriculture Subsistence, commercial, and agricultural extension Resource  (e.g. cash, labor) shortages and reduced productivity ,[object Object],[object Object],[object Object],[object Object],Loss of farm-specific  knowledge ,[object Object],[object Object],[object Object],[object Object],Institutional  capacity  and organizational change ,[object Object],[object Object],[object Object]
  AIDS     Food insecurity      Malnutrition   Downstream vulnerability Depends on quantity, quality and mix of assets at household and community levels, institutional context and processes. AIDS impoverishes (directly and indirectly) Intra-household effects (women, children)
More volatile food prices Source: Data from FAO 2009 and IMF 2009. Prices fell as financial crisis and recession developed
Food prices and food crises ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How to respond? Agriculture Social protection HIV programs Nutrition/health programs Livelihood/food insecurity HIV & AIDS Malnutrition
  HIV   AIDS prevention   mitigation   Food insecurity    Malnutrition   care & treatment HIV strategies
Securing Livelihoods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],NEEDS INTERVENTIONS Malawi’s Draft Social Support Programme  (Government of Malawi and UNICEF 2009) 5% 10% 25% ,[object Object],[object Object],Ultra Poor with Labour Capacity Ultra Poor & Incapacitated Moderately Poor 40%  MALAWI POVERTY LINE  15% Ultra Poor
The Regional Network on AIDS, Livelihoods and Food Security  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lessons and Challenges ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

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Poverty, Agriculture and Health: Lessons from the HIV Response

  • 1.
  • 2. The World of HIV © Copyright 2006 SASI Group (University of Sheffield) and Mark Newman (University of Michigan).
  • 3. The World of Income © Copyright 2006 SASI Group (University of Sheffield) and Mark Newman (University of Michigan).
  • 5. Three coexisting/interacting crises Livelihood/food insecurity HIV & AIDS Malnutrition
  • 6. Vulnerability of Livelihood Systems to AIDS Vulnerable Groups - Orphans, Elderly and Youth Headed Households, Effect on Institutions Community-based, Civil society, Market, State, Global Outcomes Nutrition, Food Security, Education, Community Cohesion, Income Effect on Assets Human, Financial, Social, Natural, Physical, Political Responses Individual, Household, Community Vulnerability to infection HIV Stigma and Discrimination
  • 7. HIV AIDS upstream downstream Food insecurity Malnutrition mid-stream Three stages of vulnerability
  • 8. HIV AIDS prevention mitigation Food insecurity Malnutrition care & treatment HIV strategies
  • 9.  
  • 10. HIV Food insecurity Malnutrition Upstream vulnerability
  • 11. HIV and Income Poverty
  • 12. HIV and Income Inequality
  • 13. HIV Food insecurity Malnutrition Upstream vulnerability Poverty? Wealth? Food insecurity Mobility Gender inequalities Social cohesion Hope?
  • 14. HIV AIDS Mid-stream vulnerability
  • 15. The Vicious Cycle of Malnutrition and HIV Insufficient dietary intake Malabsorption , diarrhea Altered metabolism and nutrient storage Increased HIV replication Hastened disease progression Increased morbidity Increased oxidative stress Immune suppression Nutritional deficiencies Source: Semba and Tang, 1999
  • 16. HIV AIDS Mid-stream vulnerability ART access and adherence STIs (especially HSV-2) Malnutrition Food insecurity (time, resources for care)
  • 17. AIDS Food insecurity Malnutrition Downstream vulnerability
  • 18.
  • 19. AIDS Food insecurity Malnutrition Downstream vulnerability Depends on quantity, quality and mix of assets at household and community levels, institutional context and processes. AIDS impoverishes (directly and indirectly) Intra-household effects (women, children)
  • 20. More volatile food prices Source: Data from FAO 2009 and IMF 2009. Prices fell as financial crisis and recession developed
  • 21.
  • 22. How to respond? Agriculture Social protection HIV programs Nutrition/health programs Livelihood/food insecurity HIV & AIDS Malnutrition
  • 23. HIV AIDS prevention mitigation Food insecurity Malnutrition care & treatment HIV strategies
  • 24.
  • 25.  
  • 26.
  • 27.
  • 28.
  • 29.  

Notas do Editor

  1. Direct measures of poverty, such as the percentage below $1 per day shown here do not seem to show any clear pattern between countries
  2. There is a striking association between income inequality (measured here by the GINI coefficient) and HIV – countries with higher income inequality appear to have higher HIV prevalence rates Similar patterns (slightly less clear) can be seen with other inequality measures such as the decile or quintile ratio There may be many counfounding factors here, such as differences in cultural practice (e.g. male circumcision and religion) Bubble plots such as this probably represent the limits of what can be understood from country level analysis – to find more robust relationships we need to go to regional or household level
  3. Reductions in food intake Appetite loss, mouth sores Effects of food security decline Nutrient malabsorption Diarrhea Malabsorption of fats and vitamins Metabolic alterations Increased energy, protein requirements Oxidative stress.