Singling out HIV-positive people for special food distribution

As the drought situation in Namibia nears its boiling point, it is time authorities single out HIV-positive people for special food distribution. 

I think it is important that the regional governors, councillors, headmen and those that are responsible for the distribution of drought relief consider people living with HIV and AIDS first in order for them to be able to stick to their anti-retroviral (ARV) therapy regimen.

The last 30 years have seen huge progress in the fight against the HIV pandemic. Globally, the number of new infections has dropped and more than eight million people are on ARVs. The drugs available today have given thousands of people their lives back, enabling them to work, bring up their children and play a full role in society.

HIV treatment won’t work without food. ARVs need to be taken with food, otherwise there could be severe side effects, sometimes leading to drug resistance. 

According to the World Health Organisation (WHO) titled “Nutrient requirement for people living with HIV/AIDS”, people with HIV require more food because they have higher nutritional requirements than uninfected people. For example, an adult living with the virus has on average a 10-30 percent higher energy requirement than a healthy adult without HIV, while for an HIV positive child the energy requirements are 50-100 percent higher. 

The publication further states that high energy diet supports the work of ARV drugs in the body, by allowing the body to burn energy while it utilises ARV drugs that help the body fight infections and build immunity. This diet provides the nutrition that an already weakened immune system needs and enables that person to cope better with the side effects of the HIV medication.

The prevailing severe drought in Namibia has compromised the health of thousands of people living with HIV/AIDS. Approximately one third (778 000) of Namibia’s entire population (2.3 million) is facing food shortages, a situation that is eroding efforts to fight the virus in areas worst hit by the drought.

Traditionally, Namibians depend on agriculture and livestock rearing for survival. 

Since Namibian President Hifikepunye Pohamba declared a national emergency on May 17, 2013, in response to the country’s failed rains and worsening drought situation, donations have been rolling in. 

The Commonwealth Heads of Mission were among the latest to respond to Namibia's appeal to the international community to help the country feed its severely affected communities through the provision of humanitarian assistance, especially food items.

Drought and HIV is a dangerous combination because lack of food is a widely acknowledged barrier to successful ARV therapy. It interferes with the body’s ability to absorb ARVs. Insufficient food to accompany ARVs causes serious nausea, loss of appetite, leaves a metallic taste in the mouth, and increases incidents of diarrhoea, vomiting, and severe abdominal cramps.

Failure to take drugs properly can have dire consequences for both the individual and the HIV pandemic as a whole. ARVs demand strict adherence, greater than 95 percent, to work properly. For a twice daily regime, this means missing no more than three doses a month and sticking to this regime year after year. 

If there is poor adherence then there is a higher risk that drug resistance will develop, which will result in the need for second line drug treatment. 

This can be more difficult to administer and the cost implications considerable. If people living with HIV require second-line treatment, it can be 10 times more expensive.

Although no cases have been reported in Namibia yet, HIV-positive patients could soon stop taking ARV therapy because of lack of food, as most of the patients cannot afford to buy enough food. 

Yes, I understand that the Secretary General of the Lutheran World Federation (LWF), Martin Jonge, has initiated a R100 short-term grant for 4 000 drought-affected people but will that be enough to buy food to last a month.

Maybe that could be a topic for another day. 

In an interview with IRIN/PlusNews, Michael Mulondo, of the Namibian Network of AIDS Organisations (NANASO), also expressed concern about the impact of food insecurity on people taking ARVs. 

“The challenge many of these communities are having is that when they return from the clinic, they lack nutrition, and that's an issue of poverty,” he said.

Eradicating extreme hunger and HIV/AIDS and other diseases are two of the eight United Nations Millennium Development Goals to be achieved by 2015 and I strongly believe that  the complex interaction between HIV infection and nutrition seriously threatens the achievement of these goals.

September 2013
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