Potential uses of food aid to support HIV/AIDS mitigation activities in Sub-Saharan Africa

• people infected with HIV/AIDS are frequently unable to work for increasingly long periods of time, undermining either (or both) earnings and food production activities, and eventually creating a gap in household labor and earnings
• family members are drawn away from production or income generation activities to care for sick relatives
• households divest tangible assets, savings, and income for medical care rather than productive activities
• children are withdrawn from school because of lack of resources to pay school fees, to care for sick relatives and to generate income
• constraints on household labor result in changes in agricultural production, including reduction in the area cultivated, shifts to less labor intensive crops and reductions in livestock
• there is a loss of inter-generational knowledge about crop and livestock production methods
• there is increased malnutrition among children in households affected by HIV/AIDS
• there is an increased susceptibility to other illnesses (for both HIV-infected and non-infected people) as food intake declines

factors to consider in planning interventions include:

• the experiences of both urban and rural community-based organizations in Africa will need to be incorporated in dealing with the impact of HIV/AIDS
• targeting individuals, households and communities for food assistance is a challenging process and will require flexibility in eligibility criteria and distribution structures. Like other poverty alleviation programs, there are justifiable issues concerning dependency and the possible misallocation of food to people without extraordinary need, and these may not be easily resolved in the context of food aid for HIV/AIDS mitigation
• determining when to intervene with food aid and at what level (e.g., direct to individuals or households, households with a person living with HIV/AIDS or those that have lost one or more family members) will require established, but flexible, criteria. The sequential and cumulative impact of HIV/AIDS on households and communities varies, in terms of the number of members infected, the timing of the infections, and the timing of the onset of symptoms associated with full-blown AIDS
• The purpose and form of food aid will vary with target groups and the timing of interventions