PEPFAR
HIV, Food Security & NutritionSocioeconomic Impact
Jason WolfeUSAID Office of HIV/AIDS
AIDS 2012 - Turning the Tide Together
HIV & Food Security
HIV exacerbates food insecurity & vulnerability:• Increased costs• Reduced labor• Diminished earnings• Liquidated assets• Stressed safety nets
Food Security & HIV
Food insecurity & vulnerability exacerbates HIV :• Inhibited health-seeking behavior• Reduced access to services• Limited follow-up and adherence• Increased opportunistic infections• Diminished community support
Food Security before HIV
Cyclical fluctuations driven by seasonalitymoderated by income diversity, assets, food storage, and safety nets
Food Security after HIV
Prolonged downward trajectoryreduced ability to buffer and bounce back from shocks
increased costsfor food & healthcare
reduced labor limits food access
sale of assetslimits future productivity
sale of assetsfacilitates recovery
Coping Strategies
• Before the shock: Risk Reduction– Low risk (low return) income generation activities– Diversification of income generation activities– Insurance mechanisms: savings & assets, social ties,
credit access• After the shock: Loss Management– Stage 1: Insurance & reversible mechanisms– Stage 2: Disposal of key productive assets– Stage 3: Destitution: charity, household breakup,
migration
Segmenting by Vulnerability
VulnerabilityFood
Security Expenses Income Assets
Low Mild Some lumpsum Fluctuating Consistent
Medium Moderate No lumpsum Fluctuating Fluctuating
High Severe Little/none Little/none None
Implications for Support
Vulnerability Strategy Interventions
Low Promotion Income diversification
Medium Protection Savings & asset management
High Provision Consumption support
Pathway Approach
Sustainable graduation out of extreme vulnerabilitywith nutrition, food security, and livelihoods support
provisionsmooths consumption
nutrition supportimproves productivity
protectionbuilds assets
promotionrestores livelihoods