Hyperendemic AIDS, food insecurity and vulnerability in southern Africa

Abstract

The rapidly accelerating AIDS epidemic of the 90s and its current state of “hyperendemicity” in southern Africa have affected the levels, intensity and nature of vulnerability. Not only does HIV co-exist with widespread food insecurity and economic inequality in time and space, it interacts with these conditions. HIV incidence rates are fuelled by food insecurity while subsequent AIDS-related morbidity and mortality, in turn, further exacerbate food insecurity. These interactions play out at household and community levels. In addition, HIV and nutrition interact negatively within the human body itself. Although often hidden, interactions play out in real time at different levels from the individual to the nation state. During the evolution of AIDS epidemics there are three sequential phases of vulnerability – upstream (relating to risk of infection), midstream (individual risk of developing opportunistic infections after HIV infection) and downstream (risk of serious impacts in households or communities living with HIV). Each of these phases have particular drivers and consequences. Among poor southern Africa households, vulnerability is also dynamic in the sense that its multiple ingredients are in constant flux – and because people proactively respond to try to reduce their vulnerability. Such responses determine their resilience in the face of concurrent shocks and stresses. Highlighting work undertaken by the Regional Network on AIDS, Livelihoods and Food Security (RENEWAL), this presentation will map out the evolution in the conceptualization of vulnerability in the context of AIDS and food insecurity in southern Africa over the last decade.