Strategic approaches to HIV prevention and AIDS mitigation in rural communities and households in Sub-Saharan Africa

This paper aims to provide a suggested framework of action for FAO' s engagement in HIV/AIDS prevention and impact-mitigation in rural Sub Saharan Africa at the community and household level. It presents a list of potential activities to undertake in both high and low HIV/AIDS prevalence areas in order to contribute more effectively and significantly to preventing HIV, reducing and/or alleviating the impact of AIDS on rural households and communities. The activities proposed are mainly aimed at (1) alleviating the impact of HIV/AIDS on agriculture, food security and people's livelihoods, and (2) reducing the hardships the affected communities and households are confronted with.

More specifically, HIV/AIDS has the following problematic effects:

• loss of labour. family members and People Living With HIV/AIDS (PLWHA) are drawn away from production and other income-generating activities to care for sick relatives, orphans or themselves
• loss of capital. households are forced to divest their income, tangible assets and savings for medical care, funeral expenses, and other immediate expenses
• food insecurity increases. food security is affected both in terms of quantity and in terms of quality as a consequence of a drastic decline in productivity of the household unit
• loss of opportunities. children are withdrawn from school due to lack of resources but also because extra-labour is urgently needed
• at the level of the national economy, the combination of a decline in food production, the sale of food reserves and diminished sources of income cause food shortages and long-term nutritional deficiencies. Moreover, AIDS is an expensive disease and taking care of AIDS patients is a twenty-four hour job. This does not leave much time to invest in other activities, hence the reliance of affected families on community support groups as well as the extended family for food, support, labour and money augmentation

The article makes the following policy recommendations:

• urge policymakers to look at and consider the potentially important impact of economic and agricultural policies on the course of the epidemic and thus on food and livelihood security (whether these policies increase or decrease the spread of AIDS)
• develop policies that continue to address the structural factors of poverty especially those that make rural households vulnerable to the impact of HIV/AIDS
• foster active participation of people infected with AIDS, affected communities and support groups in policy development