118741
11/16/2011 - 17:20
Fight Against HIV/AIDS

The day starts with a visit to a tuberculosis clinic at Bamyan Hospital. Afghanistan has one of the highest TB infection rates in the world, so providing food to patients getting treatment is an important part of WFP’s work. Firstly, because the food incentive encourages people to see through the whole course of treatment, which lasts eight months. And secondly, because getting enough food is important in order to make the medicine work properly.

There are 47 patients on the books in this clinic. The youngest is Mohammed – he’s 13 years old, but looks like he’s nine, he’s so frail and delicate. He’s here with his dad to pick up the month’s ration: 50 kilos of wheat, 8 kilos of pulses and a can of oil. There should be salt too, but at the moment we’re out of stock.

Zara bundled up in the coldI get to chat a bit with Zara, who is 45 years old but looks like she’s 80. The life expectancy for a woman in Afghanistan is 45 years.  “This food is good for my health,” she explains, “and it’s also useful to my family. My husband works in the fields, but he’s old. We have seven children. We need the basics of life – like food.”

We move on to visit a plant nursery in the Shash Pul valley 10km or so east of Bamyan centre. On a flat plot of land near a river, small clusters of men and women are preparing the earth and planting seeds.

The project is run by the Ministry of Agriculture and supported by WFP both with food for labourers and funding for the basic materials. Khadeja is one of five women poking holes into the ground with a stick and dropping in apricot stones. “Before this project, I had no idea about gardening. It’s a new skill I’ve learned,” she explains. “It keeps me busy and it provides me with food – much better than just being at home all day,” she giggles. “I’ve made new friends here, it’s fun.”

The trees – apricots, almonds, poplars and others – will either be used in community land management projects, or sold to wealthier members of the community who have private gardens. I’m curious to learn where these trees might end up, so we go looking for them.

Our quest takes us way over to the other side of Bamyan, about 20km to the west. West and up – we’re now nearly at 3,000 metres altitude, the wind is bitter and there is snow on the ground.

What we’re looking at is an “upper catchment watershed management” project, apparently. It’s a system of trenches held up by saplings (from a similar nursery project dating back several years), designed to prevent soil erosion, flooding, and to help replenish groundwater supplies. The latter is especially important in Bamyan, where all five of Afghanistan’s most important rivers originate.

the snowy grounds of afghanistani mountains

The vast 50-hectare site is dotted with 20,000 trees, plus 30,000 new seeds that have been planted. At the busiest time during the summer, as many as 300 people from the surrounding villages were working here.

Soon, members of the local watershed committee or shurah arrive, led by the chief, Kodan Zahar. He is bursting with pride. “Before, people did not understand why we should do this. But now they see the results – they see that the soil is better, that there is less flooding. We no longer allow our animals to graze here.”

An impromptu committee meeting  on the mountainside gives good feedback for WFP’s work: they are happy with the food deliveries and quality. And we can be happy that the saplings so diligently planted by women like Khadeja will be put to good use.

During Silke Buhr's third day in Afghanistan, she visits Bamyan Hospital and learns how important food assistance is for patients at the tuberculosis clinic. She also meets Khadeja, a woman who's found a new lease of life thanks to involvement in a plant nursery, which is indirectly helping to improve soil quality in the area.

100634
10/19/2011 - 23:50
Fight Against HIV/AIDS

Eating Habits Exclude Soy

In the nutritionist’s own words, the fact of delivering soy grains implied a true challenge to them, as they had to create a variety of recipes with these pulses. The reason is that soy grain is not a regularly consumed food, yet Bolivia produces large amounts of this pulse. For the same reason, beneficiaries encountered difficulties in the preparation of soy grain at the beginning of the project, but they added enthusiasm to the work of creating soja-based preparations as they learnt from the nutritional orientation that this pulse provides high levels of protein, extremely important for their medical treatment adherence.

Food Fair

After a year of having started the project, WFP and the health centers for people living with HIV in the cities of La Paz and El Alto organized a Soy Food Fair, in which beneficiaries showed and tasted a great variety of dishes prepared with soy: starters, soups, main courses, desserts, sweets and snacks.

Soy Becomes A Staple Food For People Living with HIV

Juana Luque Mamani lives in the city of El Alto, but comes originally from the rural areas. With 41 years, she supports her five children on her own. She confesses that more than a year ago she was diagnosed with HIV, but left the treatment almost as soon as she started it because her nutritional situation was poor and medicines made her feel even more tired and weak. However, when she realized that other people living with HIV were improving their nutritional status with WFP’s food basket and nutritional guidance, Juana decided to get back to treatment. For her and for her family, the four products of WFP’s food basket have turned into the basis of their diet. “We had never before eaten soy, we did not know it…I have received WFP’s soy recipe booklet, but I’m illiterate, so I had to create preparations with soy”, says Juana. She and her family eat soy-based food three times a week, but they drink self-made soja milk every day. Among her specialties are fritters, hamburgers and soja stew. “To me, as well as to the other people living with HIV, WFP’s support has turned into everyday’s bread…WFP has not only given us food to have a better diet, but has also taught us how to improve our nutrition.”

Soy Is Not Costly And It Is Highly Nutritious

El Alto nutritionist’s Isela Patón considers that once WFP withdraws its food aid from the project, beneficiaries will still be able to continue consuming soy as it is not costly at all and is as nutritious as other native grains such as quinoa. WFP and the National STD/HIV/AIDS Programme of the Plurinational State of Bolivia -the government institution with which the project is being run-, were extremely careful in the selection of the food basket products, basing the assortment not only on availability of the products, but also on their prices at the local markets.

Almost a year ago, WFP started a project aimed at assisting some 650 people living with HIV who were receiving antiretroviral treatment and were identified as highly food insecure. Every month, while receiving their medical treatment at the health center, these people also receive a family food basket made up of rice, soy grains, salt and vegetable oil.

32602
06/14/2011 - 11:10
Fight Against HIV/AIDS

Mndeni’s parents both died of AIDS-related illnesses in 2007 and he was left in the care of his grandmother. Mndeni was himself diagnosed HIV+ and began treatment when he was just ten months old. 

At two years of age, Mndeni started visiting the Bhobo neighbourhood care point which provides orphaned and vulnerable children with two hot meals a day, psycho-social support and  basic lessons. Bhobo Care Point is located in Nkilongo constituency on the Lubombo Plateau in the eastern part of Swaziland. 

It is among 265 such centres supported by the Government of Swaziland, non-governmental organizations, community volunteers and UN agencies including the World Food Programme.

Anti-retrovirals

"We’re grateful, especially for the food, as Mndeni was in very poor health when he started going to the care point”, says his grandmother, 73-year-old Eselinah Mdluli. “He had sores all over his body and couldn’t walk long distances.”

Gogo (Grandmother) Mdluli, as she is known in the close-knit community, is also on anti-retrovirals. She became infected with the HIV virus in 2007 and is so ill that on some days she cannot get up from the grass mat she uses as a bed.

The family’s only source of income is a government grant that  provides a monthly allowance of SZL200.00 (US $29) to elderly citizens above the age of 60.  The Mdlulis also share this stipend with seven other grandchildren under Gogo Mdluli’s care.

Food point 

They inherited these children from two daughters and a son who have left their village homes to seek employment in the main Swazi cities, Mbabane and Manzini.

“I buy food with the government money though it quickly runs out because we are so many in this family”, she says, sitting outside their grass hut. “But at least we can rely on the care point to provide food for Mndeni who is the youngest.”

Before he starts his lessons, Mndeni enjoyds a breakfast of hot fortified porridge. For lunch, he eats maize mash with beans. The caregivers say he is much healthier and more playful than he used to be. Bhobo Care Point provides support to about 55 orphans and vulnerable children.
 

NKILONGO - Life is difficult for Mndeni Mlduli, a five-year-old Swazi orphan who is HIV-positive and on anti-retroviral medicines. But thanks to a neighbourhood feeding scheme in his community in rural Swaziland, he has regained the strength and energy he needs to play and be a child again.

31833
05/05/2011 - 17:40
Focus on Women

EL PROGRESO—When Neri, 28, started coming to the Integral Care Center (CAI) in 2009, she weighed 37 kg (82 lbs). “It was a very difficult time for me,” says the young mother of three, who tested HIV+ four years ago. “Up until now, I worked for a lady making tortillas who only paid me about 60 lempiras (US $3.00) per day.”

Even in El Progreso, Honduras, a poor but growing city in the Central American country, Neri wasn’t earning enough to provide for her family. With so little money to buy food, she often had to decide between feeding her children and feeding herself.

Help a mother like Neri on mother's day
wfp staff member handing food and olive oil to neri

Many mother's around the world face agonizing choices, but you can help to give one a way out. Find out more

“I know that if I didn’t eat, the antiretroviral drugs wouldn’t work. But I couldn’t bear to hear my children cry because they were hungry,” said Neri. The worst part about it, she added, was knowing that if she didn’t eat, she would die and that her children would be orphaned.

It wasn’t until she came to CAI, where her treatment included rations of nutritious food provided by WFP, that she found a way out.

A tough spot

A single mother in one of the poorest countries in Central America, life was hard enough for Neri before she started showing symptoms of HIV. She was working ten-hour days and making barely enough to survive, let alone raise three growing kids.

“I was getting weaker and weaker and sicker and sicker,” she said. “If things had gone on like that, I don’t think I’d still be here.”

Despite all of Neri’s sacrifices, her children were also showing signs of malnutrition. When they arrived at the CAI centre, her youngest—a two-year-old named Nelson—weighed in at just 8 kg (18 lb).

women for women advertisement click to give her a way out

Since then, all of them have rebounded. Neri’s weight nearly doubled to a healthy 136 lbs and her children are back in the normal range. Because she was feeling better, Neri even had the strength to go find a better job. She now works in a restaurant that pays her more and gives her time off when she needs to come to the health centre.

young boy eating bowl of rice and beans

 

A common problem

Hunger leads to dangerous health risks on its own, but when coupled with the HIV virus, becomes especially deadly. According to experts, patients who are underweight are six times more likely to die from the disease.

That’s because their bodies can’t absorb antiretroviral medication, which slows the virus, without the right nutrition. Together, hunger and HIV create a vicious cycle of lowering income and worsening health that are impossible to escape without help.

 

Find out more about WFP's Focus on Women

Until recently, Neri, an HIV+ mother of three, often had to choose between feeding her children and feeding herself. It was an impossible choice and she might have died if she hadn't started receiving food as part of her treatment. She's now healther, better able to care for her family and was able to celebrate Mother’s Day.

29448
12/01/2010 - 12:12
Fight Against HIV/AIDS, Focus on Women, Nutrition

What have we learned about the relationship between HIV and hunger since the epidemic began almost 30 years ago?
We know that hunger is both a cause and consequence of the HIV epidemic. When a person is food insecure, they’re likely to take risks that exposes them to infection. And once you’re infected, you incur a number of illness-related costs. When people have to choose between buying food and buying medication, then HIV can deepen hunger.

What can a food aid agency like WFP do to help break that link?
If you’re living with HIV in a poor country, you have hard choices to make. If you live far away from a clinic, you’ll need transportation and that’s a cost. You also need to be eating more to stay healthy and that’s another cost, which can compete with paying the rent or sending your children to school. All of these can be barriers to treatment. Our job as WFP is to offset those barriers by making sure people have access to enough of the right kinds of food.

Mutinta Hambayi is an HIV Programme Advisor at WFP headquarters in Rome. She has a Masters Degree in Food and Nutrition from Queensland University in Australia. She has worked in Zambia, where she grew up, as well as Sudan.

Apart from propelling sick people into hunger, what effect does the virus have on food security overall?
Studies in rural communities have shown that when a family has someone infected with the virus, their crop yields can fall by as much as half. People who are sick aren’t just less productive, they need to be cared for. Families also will change crops to grow more of the ones that are easier to cultivate, but that might get a lower price at the market. That can have a big impact on income.

Obviously people who are sick need nutritious food to fight off infections. What other role does nutrition play in treating people with HIV?
When you have an infection, the body mounts a defence mechanism. If you don’t have enough food, you’re going to lose weight. We know that people who are underweight are six times more likely to die from the disease. They can’t absorb food as well and they may not be able to tolerate the side-effects of the anti-retroviral medication if they’re not eating enough.

How have women been affected by the disease?
Slightly more than half of all people living with HIV are women (UNAIDS, 2010). Apart from being anatomically more vulnerable to infection, there’s growing evidence that economic dependence on men can also drive the spread of the disease. It makes them more vulnerable to exploitation, less able to insist on safe-sex practices and less likely to leave violent or dangerous relationships. All of these are risk factors to infection.

What was it like to grow up in Zambia, one of the countries hit hardest by the epidemic?
woman standing in front of an hiv logoGrowing up in a country with a high HIV prevalence, you’re confronted everyday by the realities of life with HIV. You’d see people on the street and be able to tell just by looking at them that they were sick. I've known a lot of them and I've been to a lot of funerals.

When you go back to Zambia, does it seem like things are getting better or worse?
I think things are getting better. You no longer see people who are visibly sick. And people who are infected no longer have to live with the stigma—particularly women. It used to be that when someone was diagnosed, people were afraid to be around them. But now people understand that it’s a manageable disease and if you receive treatment and proper nutrition, you can be as healthy as the next person.

wfp staff working around a table featuring the aids awareness logoA fight on two fronts

WFP works in over 50 of the countries hardest hit by the AIDS epidemic to ensure that people infected with the disease get the nutrition they need to stay healthy. That involves feeding people in clinics and making sure their families and support networks have the resources to care for them. Find out more

 

As we remember all those living with the HIV virus on World AIDS Day, millions of people with the disease are barred by hunger from leading the healthy and productive lives that they could have with treatment. Zambia-born nutritionist Mutinta Humbayi says that by breaking down those barriers, we can help stop a vicious cycle driving the epidemic.

28278
09/24/2010 - 09:51
Fight Against HIV/AIDS, Focus on Women, Purchase for Progress

NAIROBI – Getting back to work wasn’t easy for Anne, 42, a small farmer in AIDS-ravaged western Kenya. The illness had taken its toll on her, and only with the help of nutritional support from WFP was she able to endure the regimen of anti-retroviral drugs keeping the virus at bay.

“I was too weak to farm and couldn’t do much work,” she said. “So I had to stop for a while. Thankfully, I was given food to eat together with the medicine, which helped me recover my strength.”

Purchase for Progress

farmer standing in a lush fieldP4P leverages WFP's own buying power to help poor farmers become competetive players on local markets. Find out more

Proper nutrition is essential for people undergoing drug-therapy for HIV, as it improves the medicine’s uptake in the system, reduces side-effects and bolsters their willpower to keep taking the pills.

Back to work

Though the food and drugs helped to restore Anne’s health, getting back to work on her farm still presented a daunting challenge. Fortunately, she didn’t have to go it alone.

Anne’s farmers organisation, the Kaptebee Sachangwan cooperative, enrolled with the Purchase for Progress initiative, a pilot project that trained her how to raise her yields and improve the quality of her crops.

Just as importantly, she learned about storage methods that allow her to delay selling her crops until after the harvest season, when prices are higher.

Looking forward

anne sorting corn

Anne’s farmers' cooperative was able to secure an important contract with WFP after proving that they could meet quality standards.

WFP purchased some 61 metric tons of corn from the farmers this year, ten bags of which came from Anne’s family plot. The sale made her US $292, which she used to pay her daughters school fees, buy seeds and fertilizer and less an extra 1.5 acres of land.

Anne is confident her yields this year will be significantly higher than last year, and that she will be able to feed her family in the future on her own.

Anne Rono is a small farmer, but after contracting HIV, lost the strength to farm her land. With the help of antiretroviral drugs and nutritious food, she’s not only back on her feet but selling her crops to WFP through an innovative new programme that links small farmers to markets.

27037
07/19/2010 - 14:31
ED - J.Sheeran, Fight Against HIV/AIDS

The global AIDS response is working. Today, people with HIV are living longer thanks to better access to antiretroviral treatment.

Even so, two out of three people who need treatment for HIV have no access to antiretroviral therapy.  And even for the lucky ones like Miriam, a 28-year-old single mother of two who was accepted into a program for free antiretroviral drugs in Dar es Salaam, Tanzania, the circumstances can be challenging.

Despite receiving medicine, her situation was worsening. She was losing weight and getting sicker.

“Sometimes I had to skip the medicines up to five days because of lack of food,” she says, explaining that the drugs, taken on an empty stomach, made her violently ill.

Fortunately, a local health worker recognised Miriam’s plight and arranged for food assistance. After nine months she regained her strength and had secured a $50 grant to re-start her small donut-selling business in the local market.  “Food support kept me alive.  Had I been sent back to my home village, I would have died by now.”

Miriam’s story says it all: antiretroviral drugs alone will not ensure successful HIV treatment. Today, effective drugs to treat HIV are reaching record numbers. Some five million people in low and middle income countries are receiving antiretroviral therapy – a tenfold gain over the previous five years.

HIV alters a person’s metabolism, affecting appetite and also impeding the body’s ability to digest and absorb the nutrients in food.  While the body struggles to fight the disease, it also requires more calories; an adult can need up to 30 per cent more calories, while a child with AIDS can require 50 to 100 per cent more calories to fight the disease.

Unfortunately many of the people affected are also very poor and, therefore, cannot afford a healthy diet. HIV makes poverty worse. HIV related illnesses affects people’s ability to work while also often raising household expenses, for example in order to pay for the transport to the clinic. While many people have too little to eat before they get sick, others have to skip a meal to make ends meet only once HIV strikes their lives. In both cases it is a tragedy. While their body needs more and better food, it gets less.

It is not surprising, therefore, that recent studies have shown the link between good nutrition and successful uptake of and adherence to treatment. Only a person who takes up treatment and adheres to it can return to a relatively healthy life. This also means that including nutritional support to people living with HIV and giving them food when they are poor can be crucial in keeping them alive.

That’s why UNAIDS and the UN World Food Programme are calling for better integration of food and nutrition assistance in all aspects of HIV programmes. To mitigate the impact of the disease on people living with HIV’s health and their families’ livelihoods, we must reshape nutrition assistance as part of comprehensive treatment for people living with HIV.

Without access to adequate and nutritious foods at the right time, lives are put at risk, medications are not as efficient as they should be and patients leave treatment programmes that could have sustained their lives and the lives of their families. The sick and hungry cannot wait.

Josette Sheeran is Executive Director of the UN World Food Programme

Michel Sidibé is Executive Director of UNAIDS

 

The world is making huge strides in the fight against HIV/AIDS through prevention and anti-retroviral drugs. However recent studies have shown that drugs alone cannot keep the virus at bay without proper nutrition. In this joint article, WFP Executive Director Josette Sheeran and UNAIDS Executive Director Michel Sidibé explain why.

27036
07/19/2010 - 12:20
Fight Against HIV/AIDS

By Mutinta Chiseko

LUSAKA – Life was never easy in the Kafue district of southern Zambia, but Mary Mweetwa, 32, said the realities of poverty and hunger never weighed so heavily as the day in March 2009 when she tested positive for the HIV virus.

A working mother of three, Mary recalls the feeling of weakness and frequent bouts of illness that led her to the hospital for testing. She was fortunate enough to be placed on Anti-Retroviral Treatment (ART) and prescribed to take a battery of drugs with side-effects of their own.

AIDS 2010 logo

Too weak to work and with money running scarce, the Mweetwas’ food budget began to suffer.

Rather than deprive her children, Mary ate less herself. “I was weak and dizzy all the time. And after I took my medication, my heart would start to beat very fast and I’d have to lie down.”

But of the worst of Mary’s problems were yet to come, when she discovered a few months later that she was pregnant.

Not alone

Stories like Mary’s are common in Zambia, where the HIV epidemic has spread to 14 percent of the adult population and 16 percent of women, according to the United Nations Programme on HIV/AIDS (UNAIDS).

Cited by UNAIDS as the “most serious threat to Zambia’s development,” the HIV virus has taken a massive toll on the society, decimating the workforce and creating a generation of AIDS orphans with little or no means to care for themselves.

Until recently, Mary’s own children seemed destined to join them, along with the child in her womb.

Restoring hope

Since then,  Mary has been enrolled on a WFP food assistance plan targeting HIV-positive mothers. As a beneficiary of the Sustainable Programme for Hunger Solutions (SPLASH), she now receives a monthly ration of cornmeal, vegetable oil and beans that’s sufficient to provide her and family with three meals a day.

She says the food has given her the strength to keep up with her drug regimen, look after her kids and even do odd jobs to make a little money. “I thought I was done for, but now I’m feeling much better and even gained weight.”

When Mary started on the programme in January, she weighed just over 45 kg (90 lbs). In just six months, she gained 14 kg (30 lbs), much of it in her swelling midsection. Now eight months pregnant, she’s looking forward to meeting her new baby boy and watching him grow up.

Get the facts:

Find out more about the importance of nutrition to the fight against HIV/AIDS by downloading these fact sheets:

 

Mary Mweetwa thought the future looked grim for her kids when she tested positive for HIV last year. But she has found that with food assistance and treatment she can in fact carry on looking after her family. WFP will highlight the importance of nutrition at the AIDS 2010 conference in Vienna this week. Read news release

18583
11/30/2009 - 15:55
Fight Against HIV/AIDS, Nutrition

DAR ES SALAAM -- Prisca Siza’s positive test for HIV came to her like a death sentence passed down by a particularly cruel judge.

“I was very, very scared when I was first diagnosed,” she says. “I thought I would just die straight away.”

The 37 year-old widow (her husband died of and AIDS-related illness over 10 years ago) and mother to three children, two of whom are not her own, had good reason to be fearful. Soon, as the illness crept into her, she weakened to the point where it was painful and exhausting to do even the most basic household tasks. 

"More Effective Treatment"

Martin Bloem headshotSpeaking on the eve of World AIDS Day 2009, WFP's Chief of Nutrition and HIV/AIDS Martin Bloem highlights how good nutrition increases the effectiveness of the drugs used in HIV treatment. Read interview

Chance of success

But then she enrolled at a centre in Tageta, about 15 kilometres north of the Tanzanian capital Dar es Salaam, where the Roman Catholic Archdiocese and WFP are working together to ensure orphans and people on anti-retroviral treatment for HIV have at least the decent diet necessary for their treatment to have a chance of success.

“After five months I am feeling much better,” she says. “Before, I couldn’t even carry a bucket. Now I am growing a small amount of maize, cassava and other crops around my home – before it was impossible for me even to think of going to work in the fields.”

“The food part of our programme is vital because when people are taking their medicine, in order for it to be effective, they need to be eating well,” says Dr Pauline Archard, the coordinator of the HIV/AIDS programme for one of WFP’s partners in Tanzania, the Roman Catholic Archdiocese of Dar es Salaam. “It helps them remain strong and to continue with their treatment.”

Prisca sitting in a classroom among other adultsMajor improvement

Dealing with the stigma associated with her HIV status is sometimes tricky. But for Prisca, things have improved to the point where some of her neighbours are wondering how she has managed to make such a major improvement in her health.

“Initially, some people did try to ostracise me but I realized that I had to just get used to it – there was nothing I could do about them. Now I speak openly to everyone. People generally accept me – some are even saying that I am not HIV-positive because they have seen me became so healthy again!”

The best news of all came recently when her one natural son was tested for HIV and returned a negative sample.

“My life is full of hope,” Prisca says with a soft smile.

Factbox

  • WFP currently operates HIV programmes in 51 countries and last year reached 3 million people living with HIV. Read more
  • Some 77 percent of these people are in sub-saharan Africa, which is also where around 70 percent of new infections occur.  
  • WFP is a co-sponsor of UNAIDS, joining other UN agencies and organisations in a common campaign to help to prevent new HIV/AIDS infections, care for those already infected and mitigate the impact of the epidemic.

 

To support children orphaned by AIDS and those living with HIV/AIDS themselves, WFP provides food and nutrition to 2.3 million people across Africa. Those on anti-retroviral treatment are particularly in need of a nutritious diet to ensure that their drug therapy is as effective as possible.

18581
11/30/2009 - 12:53
Fight Against HIV/AIDS, Nutrition

Martin Bloem, headshotWhy has nutrition taken on a much greater importance in the treatment of people living with HIV recently?

Food has long been regarded as an important part of any comprehensive treatment plan but there has definitely been a critical shift in thinking recently – a shift that puts greater emphasis on the need for nutrition to be integrated into all HIV treatment programmes.

In the past, food was viewed primarily as a means of helping patients to adhere to treatment by helping them to cope with the side-effects of the anti-retroviral drugs. But gradually it has become clear that in the developing world, better nutrition plays a far more important role – by increasing the effectiveness of the treatment.

In the developing world, there is a higher mortality rate for people on ART (anti-retroviral therapy) than in the richer world – largely because people in developing countries first seek treatment when they are already malnourished and wasted.

In these cases, complementary food assistance increases the chances that the treatment will work and that the patient will survive. And that is why nutrition is now viewed as a critical complementary component of any effective treatment plan and why it has been written into protocols for the treatment of HIV for the very first time – because it helps people living with HIV to survive.

But the drugs do work on their own – so shouldn’t we be focusing on expanding drug provision rather than using scarce resources to provide food?

There is a need to continue expanding access to anti-retrovirals since government roll outs in recent years have proven so successful – and the primary focus should be on the drugs since they are the first and most essential part of any treatment programme.

But it is clear that a programme involving both drugs and well designed nutritional support does improve the chances of survival. There is also evidence that patients with a very low body mass index can survive on the drugs but without targeted food support, they struggle to improve their body mass index and grow strong enough to return to a full and productive life.

Is it clear yet what kind of food assistance works best?

We are learning very quickly and starting to develop guidelines and protocols but we do still need more evidence before we can say for sure what is best.

However, the basic outlines are clearer now. In the critical first six weeks to three months, malnourished patients require specialized and highly nutritious foods to improve their lean body mass, which helps their immune system to recover. But later on, food such as corn-soya blend could be used instead. And even later, the focus can switch to providing micronutrients rather than actual food commodities.

Beyond that there are possibilities to provide food assistance as part of social safety nets for the patients and their families and in the longer term, livelihood assistance as well so that people on treatment can once again take care of themselves and their families.

What exactly is WFP's role in HIV treatment programmes?

As one of the experts in the field of nutrition, we have a role to play in both practical and policy terms. In many parts of Africa, WFP is helping to provide vital nutritional support to people living with HIV and a much larger number of people affected by the pandemic – and we are refining our assistance all the time to make it even more effective. Working with governments, ministries of health and other partners, we are helping people to survive.

In other areas – such as Latin America and Asia – WFP is helping to build local capacity and provide technical expertise.

And globally, WFP is working with partners to develop the most effective treatment guidelines and protocols, including what are the best foods, how long should they be provided and how best to actually provide them.

But is traditional food aid the answer in the specific case of HIV treatment?

As an organization, WFP is rapidly moving away from traditional food aid towards food assistance – using innovative new methods to assist the most vulnerable. And this is certainly the case in relation to HIV treatment. We are experimenting with a range of new tools, including food vouchers and mobile transfer technology and seeking partnerships with the private sector. WFP is thinking far more broadly nowadays and this can only enhance our ability to help boost HIV treatment in some of the poorest and hardest hit parts of the world.

Speaking to wfp.org on the eve of World AIDS Day 2009, WFP's Chief of Nutrition and HIV/AIDS Martin Bloem highlights how good nutrition increases the effectiveness of the drugs used in HIV treatment.