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