HIV remains one of the great challenges of our time. More people than ever – an estimated 36.9 million – are infected, with adolescent girls and young women disproportionately affected. Tuberculosis (TB) is a leading killer of HIV-positive people: People living with HIV are from 26-31 times more likely to develop TB than those without HIV.
HIV can trap those it affects in a downward spiral: People living with HIV and TB need more calories and nutrients in their diet in order to strengthen their immune system, but they often have poorer appetites and are less able to absorb the nutrients in their food. HIV also increases susceptibility to diarrhoea and infections.
If left untreated, HIV gradually destroys the immune system and results in weight loss and wasting, often worsening existing malnutrition. At the same time, HIV patients who begin treatment when they are malnourished are three to five times more likely to die than those who are not.
HIV is most prevalent in areas of widespread poverty and food insecurity, affecting populations with already limited access to a healthy diet. HIV and TB often compound pre-existing food insecurity and malnutrition in a vicious cycle: Costs of medical care and loss of income (due to prolonged illness or stigma) increase food insecurity, while people who are food-insecure often engage in risky coping behavior which may put them at risk of HIV infection. Food insecure people are also less likely to adhere to treatment.
The integration of a comprehensive food and nutrition component in the HIV and TB treatment and support package is critical in ensuring better health outcomes for people living with these conditions.
WFP's work in HIV/TB
People living with HIV and/or TB are an important consideration in our nutrition programming. Within the Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Food Programme (WFP) is the lead agency for ensuring that food and nutrition support is integrated into national HIV and TB strategies and provided to patients when needed. In 2015, WFP’s HIV and TB programmes reached 540,000 people.
Along with UNHCR, WFP co-convenes the area of HIV in humanitarian settings. Our work is in line with UNAID’s 90-90-90 treatment targets to help end the AIDS epidemic, and with the new UNAIDS strategy for 2016–2021, Fast-Tracking to Zero, one of the first in the United Nations system strategy to be aligned with the Sustainable Development Goals.
HIV in emergencies
During humanitarian crises, access to health care services and availability of drugs for people living with HIV and/or TB may be disrupted, and patients may find it hard to meet their nutritional needs, further risking their health. WFP’s recognizes that good nutrition plays an important role in a crisis situation by ensuring that patients continue to access treatment. Our emergency response aims to ensure that affected people have access to essential food and nutrition support.
Providing support to malnourished HIV and TB patients
On the ground, WFP works with governments in emergency, but also recovery and development contexts to support HIV and TB patients and their families. We do this through nutrition assessment, counselling and providing food and nutrition support in the form of specialized nutritious food.
WFP also contributes to implementing safety nets in the form of food, cash and vouchers which are designed to soften the immediate consequences of HIV and TB on food insecure individuals and their families.
Considering HIV in all interventions
More and more, WFP is exploring HIV-sensitive approaches – programmes not specifically designed for HIV patients, but where they are considered in planning as part of the target group. In this regard, WFP is designing its activities such as General Distribution, Food for Assets and School Feeding with HIV patients in mind. We are also supporting governments and partners to adequately include people affected by HIV into broader social protection schemes.
All WFP programmes include activities that aim to enable countries and communities to sustain their own development. In the area of HIV and TB, we work directly with governments and other national actors to support the development of strategies that integrate food and nutrition insecurity for people living with these conditions.