Potential role of food aid for AIDS mitigation in East Africa : stakeholder views

Most stakeholders agreed that food aid can help impoverished African households cope with the HIV/AIDS crisis. AIDS is unique in that it calls for both emergency humanitarian assistance and traditional development assistance response. Two potentially problematic issues were raised frequently: how to avoid creating dependency on external food aid, and the lack of sustainability of programs that only offer food. Among the suggestions offered most consistently regarding program design were the following: (1) Food aid should be provided as part of a larger development package rather than as an isolated program. (2) Combining food aid with income-generating activities can help households deal with their reduced access to food and can build self-sufficiency in coping with the death of a family member from AIDS. However, such projects must take into consideration the special conditions created by AIDS (in particular the waning health of one or more adult family member), and the need to provide money management skills along with technical skills. (3) Targeting food aid -- e.g., to PLWHAs, child- or grandparent-headed households, and AIDS orphans -- is complicated by numerous factors, but is critical to program success. (4) Consultations with affected communities on how to structure, target, and deliver food aid should be sought during the planning stage of any food aid program. (5) Politically motivated interventions should be avoided. (6) Use of locally grown foods, in combination with food from external sources, can help avoid creating dependency on food aid. (7) Countries are at different points in their national response to AIDS. While Uganda long ago accepted the AIDS crisis and began developing programs to confront it, Kenya has been far slower in acknowledging the depth of the crisis. Thus a program that works in Uganda might not be effective in Kenya, where the AIDS stigma still prevails. To improve the design of food aid programs, stakeholders recommended more detailed research into the different coping strategies adopted in urban and rural settings. For example, while some households respond to AIDS by withdrawing children from school to utilize their labor and avoid paying school fees, others reduce the quantity or quality of food consumed so that children can continue their education. Other suggestions for research concerned: the best combination of food and medications to enhance the quality of life for PLWHAs; food aid as a weaning food for HIV-positive mothers; and the relationship between malnutrition and HIV infection. (Author abstract, modified)