[pronut-hiv] Hunger: The hidden threat to HIV/AIDS persons (2)

["martin kumbe" <martinkumbe72@yahoo.com>]

The food insecurity in some parts of Uganda attributed to prolonged drought with the attendant impact on the health of HIV positve persons is clearly identical to the Kenyan scenario if not worse.

Most parts of the country-Kenya- have not received long rains ,if any, these have been delayed, therefore not sufficient for the sustenance of crops for good yields. This has had the effect of compromising any expected harvest of the main planting season that most farming communities depend on for their annual food basket. It is apparent that meaningfull planting this year has been put on hold untill the onset of long rains sometimes next year. Rural communities are obviously bearing the brunt of all these adverse circumstances. 

The situation has been compounded by high inflation which stood at 26.2 per cent last year, the highest in close to two dacades. Though the inflation has eased up in the recent months to stand at 17.8 per cent, it is still relatively high and has pushed up the prices of most food commodities.  In the last 18 months food prices have gone up by 63 per cent with the prices of essetial commondities doubling.  All this has happened in the context of a dismal economic growth rate of slightly less than 2 per cent from a high of slightly 7 per cent in December, 2009. 

The import of all these is that rural households' food access capacity has been gravely dimished due to poor harvests as the whole season has been lost. On the other hand, the economic vagaries have reduded if not eliminated urban- rural flow of remitances as well as significantly eroding household purchasing power. The situation in urban centres is not any different where a majority, concetrated in the informal settlements, survive on meagre incomes. 

Fact file on hunger paints a grim projection of the situtaion: Experts warn the famine situation is expected to become worse due to prolonged drought , more than 10 million kenyans face hunger as a result, farmers in the North Rift-Kenyaâs bread basket-are worried over the fate of crops as rains delay.
 
What does this potent for HIV positive persons representing one of the groups most vulnerable to food insecurity? Obviously, a casual observation indicate that the situtaion in Uganda could be at play in most parts in Kenya , where, due to hunger pangs, those on ARVs medication may not be adhering to the prescription therefore compromising the effectiveness of the drugs. Coincidentaly, it has been reported that regions like ÂNyanza province which have reported some of the highest HIV prevalence levels in the country are on the brink of  massive famine after farmers recorded one of the poorest harvests this year. 

Bottom line: There is need for urgent resource mobilisation for the delivery of nutrition interventions to HIV positive persons to reduce deterioration of their health through food aid aimed at improving nutritional status as well as promoting optimal adherence in the use of ARVs and other medication. The focus should be on those expectant and lactating, under-fives as well as malnourished adults and those at risk of malnutrition. If this is not done as a matter of urgency, the health sector will find itself dealing with an extreamly complex situation in near future. It is my conviction that relatively fewer resources will be required to attend to this crisis compared to the management of the consequences in a few months to come. 

The Minstry of Health in Uganda seems to have moved with speed in its initial response to the situation. Where do we stand in Kenya?

Martin Kumbe,Nutritionist, Kenya