Study Paper No. 6THE IMPLICATIONS OF HIV/AIDS FOR RURAL DEVELOPMENT POLICY AND PROGRAMMING: Focus on Sub-Saharan Africaby Daphne Topouzis, PhD, Sustainable
Development Department, FAO EXECUTIVE
SUMMARY
This paper examines the implications of the HIV epidemic for rural development policies and programmes in sub-Saharan Africa and, in particular: the inter-relationships between rural development and HIV/AIDS; and the broad policy and programming challenges that the epidemic poses for rural institutions. The proposed conceptual framework for the identification of key policy and programming issues for rural development raised by HIV is intended to provide guidance for the design and conduct of a set of four case studies to be carried out in Southern and Eastern Africa. The main objective of the case studies will be to help formal and informal rural institutions generate policy and programme responses to the HIV epidemic (in the areas of land tenure, agricultural research, training and extension, appropriate technology, credit, etc.) in each of the four countries. The relationships between rural institutions and HIV/AIDS are bi-directional:
The following key points cross-cut the proposed conceptual framework on the implications of HIV/AIDS for rural development policy and programming: 1. The causes and consequences of the HIV epidemic are closely associated with wider challenges to development, such as poverty, food and livelihood insecurity, gender inequality. In effect, HIV/AIDS tends to exacerbate existing development problems through its catalytic effects and systemic impact. 2. In areas heavily affected by HIV/AIDS, the catalytic effects and systemic impact of the epidemic on rural development may:
3. Given that many problems arising from the epidemic are not specific to HIV/AIDS, policy and programme responses need not be HIV/AIDS-specific but must address the root causes and consequences of the wider challenges to rural development. In other words, a developmental rather than an AIDS-specific focus is critical to tackling the multi-sectoral complexity of the epidemic and its systemic impact and to ensuring the sustainability of both HIV/AIDS responses and rural development efforts. 4. The policy environment plays a key role in defining the parameters of susceptibility/vulnerability to HIV/AIDS and of the impact of the epidemic. 5. Gender, age and marital/family status play as decisive a role in determining susceptibility/vulnerability to HIV/AIDS and the potential impact of the epidemic as economic and cultural conditions. For this reason, the interplay between these factors needs to be considered at each stage of policy and programme development. 6. The policy and strategy recommendations put forth by the World Conference on Agrarian Reform and Rural Development and by the World Food Summit in particular provide a springboard from which to mainstream HIV/AIDS in rural development policies and programmes. In particular, WCARRD's focus on poverty alleviation and participation by rural people in the institutions that govern their lives as a basic human right, and the World Food Summit emphasis on food security and sustainable human development are not only prerequisites for the revitalisation of the rural economy, but also for effective responses to HIV/AIDS. 7. Rural development policies and programmes in support of poverty alleviation, food and livelihood security, the empowerment of rural women, etc. are, in effect, also HIV prevention and AIDS mitigation measures and vice versa. 8. While rural development programmes can be integrated with HIV/AIDS prevention and mitigation programmes, HIV/AIDS-specific policies and programmes have an important complementary role to play. The proposed conceptual framework focuses on selected rural development focus areas, and in particular on: Poverty alleviation: This section examines the broad inter-relationships between poverty and HIV, identifying gaps in knowledge (i.e. on household coping strategies), critical issues that are not currently being addressed (such as the consequences of HIV-related inter-generational poverty and of the increasing asset/land concentration and marginalisation of the poor) and alternative targeting criteria (such as adult death and/or household dependency ratios) for poverty alleviation programmes. Food security and sustainable livelihoods: The dynamics of labour mobility/ migration and food security/sustainable livelihoods are critical dimensions of HIV transmission and impact. This section raises the issue of the sustainability of labour-intensive food production strategies, upon which food security policies and programmes are often based, given labour shortages arising from HIV/AIDS, drought, migration and other factors. The issues of labour shortage and livelihood insecurity and of food/livelihood security coping mechanisms of informal rural institutions to HIV/AIDS impact are also examined. Empowerment of rural women: Gender inequality facilitates the spread of HIV and exacerbates its impact. This section examines: a) the gender-specific impact of young adult mortality; the gender (and age/marital status) differentiated effects of HIV on household income and expenditures; and c) the interface between formal and informal rural institutions, gender and HIV/AIDS as manifested in traditional social safety net mechanisms for women, such as widow inheritance, and the implications of the adverse effects of such practices for women. Labour: The heterogeneity of labour is highlighted as a critical factor in the analysis of the impact of the epidemic. Human rights, production and productivity issues, employment and labour market issues resulting from the impact of HIV/AIDS are examined in terms of their policy and programme development implications. More specifically: the role of the workplace in HIV prevention; lost skills and experience; the substitutability of labour; losses in production and rising payroll costs are analysed in the context of HIV/AIDS. Infrastructure: The implications of construction, maintenance and operation of rural infrastructure are examined in terms of their potential positive or negative contribution to the spread and impact of the epidemic. The impact of HIV/AIDS on rural housing, and thus on rural living conditions, is also examined. Participatory, gender-sensitive and multi-sectoral rural development policies and programmes are essential elements of any response to HIV/AIDS. The need to develop capacity-building strategies to improve the planning capabilities of agricultural and rural development institutions and to help them cope with the loss in human resources and other effects of the epidemic is underscored. Rural institutional strengthening and capacity-building activities that will also assist the case studies to generate policy and programme responses may include one or several of the following components of the menu of options proposed below: a) Rural development sector/sub-sector susceptibility/vulnerability assessment (why and how is a sector/sub-sector vulnerable to HIV/AIDS? which population/employee groups are most susceptible/ vulnerable? How do labour conditions facilitate HIV transmission? etc.) b) Human resource needs/capacity assessment of public and private rural development institutions, to evaluate the degree to which their policies and programmes are aligned with the effects of the epidemic and with the implications of human resource losses. c) Participatory training for rural institutions and their clients/target groups in: bottom-up, cross-sectoral, gender-sensitive planning; the implications of HIV/AIDS for rural development; and mechanisms that move field-based information on the bi-directional relationships between HIV and rural development up the planning ladder so as to influence how planners and policy-makers think, how they plan responses and set policies. d) Policy/programme review (national and district level rural development policies and plans, etc) to take into account the dynamics and impact of the epidemic; to enhance multi-sectoral collaboration among rural development programmes; and to integrate rural development programmes with HIV/AIDS prevention and mitigation programmes. e) Creating a mandate on HIV/AIDS and generating political commitment at the highest level for HIV/AIDS. f) Setting up a Management Information System on HIV/AIDS in rural areas. The author would like to thank Emmanuel Chengu, Rural Development Analysis Officer of FAO, for his thoughtful and insightful comments on the inter-relationships between HIV and rural institutions. Jacques du Guerny, Chief of FAO's Population Programme Service and AIDS focal point, provided valuable comments on the framework, outline and early drafts of the paper. Desmond Cohen of UNDP's HIV and Development Programme contributed many good ideas, particularly with regard to HIV, poverty and rural development, and indefatigably responded to all my questions. I am especially grateful for his sharing with me a draft of his paper on "Poverty and HIV/AIDS in sub-Saharan Africa," which I have used extensively. Guenter Hemrich, Agricultural Advisor to GTZ's Integrated Food Security Programme in Eastern Province, Kenya, provided invaluable input to the various stages of the paper, and particularly to the framework. The comments of Ms. Florence Egal (FAO ESNP), Ms. Silke Weigang (FAO SDRE), and Gabriel Rugalema, Institute of Social Studies (ISS), the Hague, are also much appreciated. Other valuable contributions were made by staff of FAO and UNDP and are gratefully acknowledged. GLOSSARY OF TERMS AND ACRONYMS AIDS:
Acquired Immune Deficiency Syndrome; the last and most
severe stage of the clinical spectrum of HIV-related
diseases.
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