HIV/AIDS, Food and Nutrition Security: The RENEWAL Initiative in Sub-Saharan Africa Stuart Gillespie and Bruce Frayne 13 August 2006, International AIDS Conference, Toronto, Canada

HIV and AIDS HIV and AIDS Food and nutrition insecurity Food and nutrition insecurity - chronic - chronic - acute - acute

Vulnerability of Livelihood Systems Vulnerable Groups - Orphans, Elderly, Female and Youth Headed Households, Effect on Institutions Community-based, Civil society, Market, State, Global Outcomes Nutrition, Food Security, Education, Community Cohesion, Income Effect on Assets Human, Financial, Social, Natural, Physical, Political Responses Individual, Household, Community Susceptibility HIV Stigma and Discrimination

Strengthening resistance to HIV and resilience to AIDS

The Regional Network on HIV/AIDS, Rural Livelihoods, and Food Security (RENEWAL) Facilitated by IFPRI, RENEWAL brings together national networks of  researchers,  policymakers,  public & private organizations, and  NGOs to focus on the interactions between HIV/AIDS and food and nutrition security.

History of RENEWAL 2000 Exploratory IFPRI work on AIDS and food security RENEWAL launched in Malawi and Uganda 2003 Network-building, think tanks, workshops Zambia and South Africa join RENEWAL 2004RENEWAL 1 (unraveling interactions) Case studies and synthesis on OVCs National advisory panels formed Regional coordinator recruited IFPRI Food Policy Review (>150 studies reviewed) Durban Conference, and book Kenya joins RENEWAL, Ethiopia start-up activities RENEWAL 2 (improving policy and programs) RENEWAL 3 (toward sustainable livelihoods)

Goal of RENEWAL To ensure food and nutrition security in the context of AIDS epidemics, and to maximize the food and nutrition sector’s contribution to a comprehensive global response to AIDS

Core pillars/processes of RENEWAL Action research Communications Capacity

RENEWAL Core Countries: Kenya, Uganda, Malawi, South Africa, Zambia

NATIONAL COORDINATOR IFPRI contract RENEWAL PROJECTS  Action Research  Capacity Strengthening  Communications Implemented by RENEWAL Partners RENEWAL DIRECTOR IFPRI - Geneva RENEWAL NETWORK FACILITATOR International Food Policy Research Institute (IFPRI) FUNDING International and country level donors & agencies PROPOSALS Developed jointly by RENEWAL Partners and IFPRI International Peer Review REGIONAL COORDINATOR IFPRI - Addis NATIONAL ADVISORY PANEL (NAP) Guides, prioritizes & endorses proposals RENEWAL NATIONAL NETWORK National Focal Institution

RENEWAL network of networks IFPRI Common principles South Africa network Kenya Uganda network Zambia network Ethiopia Malawi network

The Effects of HIV/AIDS on Agricultural Production Systems in Zambia: A Restudy CARE International Zambia International HIV/AIDS Alliance, FAO HIV/AIDS and Community Resilience in Zambia: Understanding the Implications for Food and Nutrition Policies Farming Systems Association of Zambia Ministry of Agriculture Michigan State University IFPRI Washington DC HIV/AIDS, Food and Nutrition Security in South Africa: Understanding and Responding University of Western Cape, South Africa IFPRI, Washington DC Promoting agricultural innovation in AIDS affected rural households in KwaZulu-Natal, South Africa Farmer Support Group, KwaZulu-Natal Vrije Universiteit, Amsterdam HIV/AIDS, land reform and land-based livelihoods in 3 provinces in South Africa Human Sciences Research Council, South Africa Impact of HIV/AIDS on inter- and intra- generational information flows among smallholder farmers, Malawi Chancellor College, Malawi ICRISAT-Malawi HIV/AIDS, rural livelihoods and depeasantisation in Malawi: finding pathways to social recovery CARE International Malawi Center of Social Research, Malawi University of Leiden, Netherlands Farming Systems and Resilience to HIV/AIDS in Malawi Institute for Policy Research and Analysis for Dialogue, Blantyre, Chancellor College RENEWAL 1 Studies ( )

TitlePartners Dealing with vulnerability: parents efforts to secure the future of their children RegionalUniversity of Cape Town, University of KwaZulu Natal, IFPRI, Southern Africa Vulnerability Initiative (SAVI) Tuberculosis: An Additional Tipping Stress to Poor Households in South Africa and Zambia Stellenbosch University, S.Africa; University Teaching Hospital, Zambia HIV/AIDS, Food and Nutrition Security and Urban- Rural Linkages in Southern Africa IFPRI, RENEWAL, Southern African Migration Project Impact of a Nutrition Intervention for People Living with HIV and its role in their Support Systems KenyaMoi University, AMPATH, IFPRI, Columbia University, USA, World Bank HIV/AIDS Mortality and the Role of Woodland Resources in the Maintenance of Household Food Security in Rural Limpopo Province. South Africa SUNRAE Program; University of Witwatersrand, University of Colorado at Boulder, USA Gender Issues in HIV/AIDS and Food/Nutrition security among Internally Displaced People’s Camps in Uganda UgandaMakerere University Land Ownership and Food Security in Uganda: A Study of the Use and Control of Land Among Households of Women Affected by HIV/AIDS in Four Districts Makerere University and National Community of Women Living with HIV/AIDS The Effects on Rural Livelihoods of Increasing Rates of HIV/AIDS-related Illness and Death in Zomba South, Malawi MalawiKennedy School of Government, Harvard University, Bunda College of Agriculture, Zomba Stigma/Discrimination within the HIV/AIDS, Food Security and Gender Context in Ethiopia EthiopiaFamily Health International RENEWAL RENEWAL 2 Studies ( )

RENEWAL 3 Protecting Livelihoods and Ensuring Food Security in the Time of AIDS

RENEWAL 3: Research in three major thematic areas: 1.AIDS, agriculture and livelihood security 2.AIDS, community resilience and social protection 3.AIDS and nutrition security Capacity strengthening Communications Five core countries, but now also linking with others (e.g. Zimbabwe, Tanzania, Ethiopia, DRC, Mozambique) By 2010, networks become self-governing and self- reliant.

Theme 1: AIDS, Agriculture and Livelihood Security Does food insecurity increase risk of exposure to HIV? How does HIV/AIDS interact with other stresses? Why are some households vulnerable? Why are some households resistant and/or resilient? What are the implications of multiple vulnerabilities for approaches to addressing HIV/AIDS and food and nutrition insecurity? How is agriculture affected by HIV/AIDS? How does AIDS erode agricultural assets or investment incentives? How important are these effects relative to others? How do these impacts play out over time? How do they influence agricultural sector performance? Internally, what modifications are needed so that the agricultural sector can contribute to poverty reduction in the context of AIDS? Externally, what measures should the agricultural development community employ in concert with other sectors to maximize attainment of common development goals (e.g. the MDGs)? How does the mobility of people and urban-rural linkages affect the spread of HIV and the impacts of AIDS on food and nutrition security?

Theme 1 activities Tracking dynamics of interactions –Longitudinal panel data, surveillance –INDEPTH network (APHRC, Agincourt) AIDS, fishing and livelihoods in the Great Lakes region –Kenya, Uganda, Tanzania Monitoring and evaluation of innovations/interventions –e.g. GART, KKCAF, Junior Farmer Field & Life Schools

Theme 2: AIDS, Community Resilience and Social Protection What characterizes a resistant and resilient community? How to strengthen and extend effective community responses? What is the appropriate balance between government-led and community-led responses? How can national policy learn from, and scale up, local responses? How well do broader social protection programs target and respond to changing constraints and needs of HIV-positive individuals and AIDS-affected groups and communities? What does social protection “through an AIDS lens” look like? What works (principles, processes, interventions) in protecting children affected by AIDS?

Theme 2 activities State and community in promoting resilience –Phase I: Southern Africa (Malawi, Zambia, South Africa) –Phase II:Eastern Africa (Kenya and Uganda) and India Collaborations –Joint Learning Initiative on AIDS and Children –UN & Partners Alliance on OVCs and Livelihoods –Others e.g. Oxfam Australia on resilience

Theme 3: AIDS and Nutrition Security How to link nutritional support, where needed, to ARV therapy effectively and sustainably? How to ensure sustainable nutrition security of affected households and communities? What does nutrition “through an HIV lens” look like, and what are the operational implications of rethinking nutrition from this perspective? What role does nutrition play in new approaches to AIDS-sensitive social protection?

Theme 3 activities Linking nutrition support with ARV treatment –GFATM, PEPFAR, WHO, UN SCN From short-term support to sustainable nutrition security –AMPATH (Kenya) follow-up –TASO (Uganda) linkage

Capacity strengthening New strategy to be implemented Strengthening RENEWAL’s physical network Regional capacity development workshops, and proposal development support (mentoring) Maintaining and extending research partnerships, with South-South and North-South links. Strengthening IFPRI’s capacity through mainstreaming Capacity progressively strengthened as communications increases access to relevant information Specific training and orientation in: –Thematic knowledge, research methods, data analysis skills, project management, proposal writing, writing for publication, communication skills

Communications and knowledge management “Inreach” and outreach New outreach strategy to be implemented –Messages, stakeholders, tools –Who, what, how Revamped RENEWAL website Updating living evidence base on web Tool pool (concepts, principles, methods, processes) Bibliography of key documents (links to other sites) Building on RENEWAL and Durban conference networks (links to UNAIDS, SADC, NEPAD, SARPN etc) Briefs, papers, CDs, journal articles, books

Lessons and Challenges Beware AIDS exceptionalism –Use an HIV lens, not a filter Think livelihoods, not agriculture Beware “either/or” mentality –ARVs are not the (single) answer Being comprehensive, but also focused Diversity, context-specificity…but need for scale-up Use/adapt tools to move from understanding to responding Evidence-based action (but don’t wait for last 5%!) Learn by doing (action research), by monitoring, evaluating and by communicating Innovate, document and disseminate Balancing quality, speed, and capacity Link research with action, both ways