Center for Global Development Working Paper 238, January. Damien de Walque, Harounan Kazianga, Mead Over, and Julia Vaillant (2011).

The 2007-2008 global food price crisis had a significant negative impact on welfare in developing countries.  There is reason to expect that it might affect HIV/AIDS infected individuals even more, since antriretroviral regimens require good nutrition.  However, this study of HIV-positive households in Mozambique finds that they did not exhibit welfare decreases greater than HIV-negative households.

The 2007-2008 global food crisis had a significant impact on the livelihoods of many.  The rise in food grain prices has been substantial, totalling 150% between January 2006 and June 2008.  Estimates suggest that 2.3 billion people under the $2 per day poverty line will become poorer, while 100 million others will fall into poverty as a result.  In this paper, de Walque, Kazianga, Over, and Valliant examine its impact on a particularly vulnerable population subset in the developing world: those afflicted with HIV/AIDS.

In Africa, HIV/AIDS remains the leading cause of adult mortality.  In 2008, 12.5% of adults in Mozambique were HIV positive.  Only 24% of those with advanced infection were receiving treatment as of 2007.  Antiretrovirals must be taken with food; therefore, the authors report, sufficient food is “an essential element in ensuring adherence and treatment success among HIV/AIDS patients” (1).  Patients must adhere to 95% of the antiretroviral regimen in order to experience improved health, according to medical results.  In this light, there is reason to expect that the food crisis might have had disproportionate impact on those struggling with HIV/AIDS.

Mozambique is a net food and fuel importer, therefore increasing food prices harm its welfare, particularly in urban areas where household food production is nonexistent.  The majority of HIV/AIDS afflicted individuals in Mozambique live in urban areas.

The authors use panel data from 2007-2008 to assess the relative impact of the food crisis on HIV-positive versus HIV-negative households.  The data is drawn from a World Bank survey of Maputo City, Maputo Province, Sofala, and Manica provinces.  HIV-positive individuals were identified at health facilities, interviewed in their homes, and comparison households were randomly chosen from the same neighborhood.  In total, 616 HIV-positive and 280 HIV-negative households were interviewed in two waves.  Interviews were supplemented by medical data supplied by health facilities.

They find that the food price crisis hurt both types of household in terms of income, food consumption, and nutrition, but to the credit of national health services, do not find that it hurt HIV-positive households more.  They conclude that “initiation of treatment and better services in the health facilities have counter-balanced the effect of the crisis by improving the health of patients and their labor force participation” (4).  They also find that though the crisis hurt household welfare, HIV-positive individuals did not make fewer trips to health facilities, or experience poorer treatment outcomes.

Caveats to this study include small sample sizes and the fact that treatment adherence was reported rather than observe.  Therefore, more rigorous studies are needed to conclusively support this finding.  However, this study presents interesting and suggestive evidence that though the food crisis has harmed welfare, HIV/AIDS patients are not suffering in excess of the general population.  This finding is in line with many medical studies that find that adherence to antiretroviral regimens is not significantly correlated with income.