that HIV/AIDS is no longer an exclusively health issue and that it is
affecting all sectors of the socio-economic development of countries,
IFAD is endeavouring to ensure that the HIV/AIDS problematic as it relates
to agriculture and rural development is an integral element of its rural
investment programmes. This is particularly so for its programmes in Africa,
given that of the 34.3 million adults and children living with HIV/AIDS
in the world, 24.5 million are in sub-Saharan Africa.
At the policy/strategy development level
IFAD is in the process of developing an overall strategy
to address HIV/AIDS within the framework of its lending programme. In
June 2001, IFAD developed a draft strategy aimed at guiding and strengthening
its programme operations as they relate to HIV/AIDS in East and Southern
Africa. A similar process is taking place in West and Central Africa.
These will form the basis for developing a general IFAD HIV/AIDS Strategy
for Africa, which will define key priorities and approaches for IFAD in
the region, including partnerships that will need to be fostered with
other development actors.
At the operations level
IFAD is increasingly integrating HIV/AIDS mitigation activities
into its projects in Africa. Specifically, projects are used as the platforms
for undertaking HIV/AIDS-related activities based on the advantage of
IFAD-financed projects being implemented around institutional and organizational
set-ups designed to reach and work with rural poor community groups and
households at grassroots levels.
In West and Central Africa, HIV/AIDS-related activities
have been supported by IFAD mainly by being incorporated into the extension
components of a number of projects co-financed by the World Bank. One
example is the National Agricultural Research and Extension Support Project
in Cameroon, under which training has been provided to extension staff
on sensitizing the rural population on HIV/AIDS. As a future direction
in West and Central Africa, IFAD intends to integrate HIV/AIDS components
into ongoing and future projects, with activities that aim to mitigate
the economically adverse effects of HIV/AIDS on rural households.
In East and Southern Africa, IFAD has supported and/or designed
a number of projects that have activities aimed at combating HIV/AIDS.
- Uganda Women's Effort to Save Orphans
(UWESO) Development Project. The programme, supported by IFAD since
1995 through a grant by the Belgian Survival Fund, seeks to strengthen
the capacity of UWESO to empower orphans and foster families of orphans
(the majority of whom are women), since this is the segment of the population
that has been seriously affected by the HIV/AIDS epidemic. This is achieved
through skills development, provision of access to rural financial services
and the promotion of social cohesion. The foster families are trained
in a number of skills that encompass business and micro-project management
and the management of savings and credit accounts. Training in food
and nutrition and in HIV/AIDS care and counselling complement this.
To empower the families and enable them to apply their skills, they
are provided with micro-credit to invest in income-generating activities.
Vocational training and artisinal training is provided to out-of-school
orphans. Training includes bicycle and radio repair, carpentry and tailoring.
Through this integrated approach combining capacity building and micro-credit
provision, beneficiaries have significantly increased the household
incomes, thereby allowing for more secure and sustainable livelihoods.
The UWESO initiative has become a key example of how community resilience
and coping mechanisms can be strengthened using technical training and
micro-credit as tools.
- The Nyeri Dry Area Smallholder and Community Services Development
Project (Kenya). The main objectives of this project, which was financed
by an IFAD loan and Belgian Survival Fund Grant during 1991-1999, were
to reduce mortality and morbidity and improve the overall well-being
of the rural poor in the Keinei District of Kenya. Activities focus
on health and sanitation, agricultural and irrigation development, institutional
support and group development and participation. Activities targeting
HIV/AIDS were implemented under the health, nutrition and sanitation
component of the social services development, through which district
and community health workers were trained in home-based care and counselling
of people living with HIV/AIDS.
- Rural Financial
Services Programme (Tanzania). The main goal of this programme,
which was approved by IFAD in 2000, is the sustainable increase in income,
assets and food security of rural poor households. This will be achieved
by enhancing the capacity of the rural poor to mobilize savings and
invest in income-generating activities by developing viable rural financial
systems. The programme will be offering insurance coverage to the beneficiaries
through a fund, which will cover loan defaulting for a variety of reasons,
including incapacitation/death as a result of HIV/AIDS. Beneficiaries
are required to pay 50 percent of the insurance premium, and the programme
will contribute the remaining 50 percent towards the insurance Fund.
Partnerships in the fight against HIV/AIDS
Recognizing that any effective response to HIV/AIDS must
involve partnerships between a broad coalition of actors based upon comparative
advantages, IFAD initiated the establishment of a co-operation
framework with the UNAIDS Secretariat. UNAIDS' mission is to lead,
strengthen and support an expanded response to the HIV/AIDS epidemic,
provide care and support for those infected by the disease, reduce the
vulnerability of individuals and communities to HIV/AIDS and alleviate
the socio-economic and human impact of the epidemic.
Areas identified for collaboration include:
- identifying and promoting the best practices for the prevention and
mitigation of HIV/AIDS in rural communities;
- exchanging information on HIV/AIDS-related projects in the rural and
agricultural development sector; and
- providing technical assistance by UNAIDS to IFAD in the areas of impact
alleviation and reduction of vulnerability to HIV/AIDS.
This is the beginning of a series of partnerships that IFAD
will be fostering with various actors, and particularly with civil society
organizations, in order to assure a joint effort towards HIV/AIDS prevention
and the mitigation of its impact on the livelihoods - and lives - of the
AIDS is striking at the heart of Africa, rolling back accomplishments
in health and education, and leaving society weakened at every
level. But AIDS is not the only disease threatening African lives
and livelihoods. Malaria and water-borne diseases contribute mightily
to the continent's vast daily human sacrifice to problems that
are crises in poor countries, but that in many cases have been
completely overcome in the developed world.
There are no simple cures for AIDS. But there are proven ways
of reducing its spread and reducing its impact - in developed
countries. Disease is the symptom; poverty is the cause of failure
to cope and contain. Its spread in Africa has a great deal to
do with the dislocation of normal lives, from the weakening of
family stemming from migration to seek income against the background
of desperate poverty, and from the poverty-induced consignment
of women to commercial sex as a way of making a short living.
It is also shaped by gender relations, and the difficulties that
poor women have in organizing safe lives for themselves and their
children. And reducing impact? It can be contained by access to
drugs widely available and used in rich countries - and support
to families (increasingly containing only the old and the young
- and many, many orphans) and communities jeopardized by the loss
of their economic backbone, prime age adults (the so-called disappearing
generation), and of family and social savings that are rapidly
depleted to care for the sick and compensate for the loss of earnings.
Some of this is being done in Uganda - with success. It can and
should be done across the continent. It really is not very complex.
But it has to be done rapidly and on a large scale.
The large majority of the African poor, and the large majority
of Africans effectively and consistently threatened by disease,
live in the countryside. They are very small farmers, craftsmen
and traders. That is where the battle to reduce poverty and disease
has to be fought. Paradoxically, the level of international interest
in the development of rural Africa has waned - especially at the
most crucial point of the struggle, improving rural livelihoods.
This has to be reversed. We have to address poverty and disease
where it actually is, and we have to empower poor people - economically,
socially, politically and technically - to handle and overcome
the crises and challenges they confront. Nobody believes that
development in rural Africa is easy. But many of the internal
factors that produced bitter disappointment in the past are changing
fast. Governments are becoming more interested in helping development
rather than commanding it, and political systems are in most cases
becoming more open and responsive to broader constituencies. The
history of the rich countries shows that the battle against major
infectious diseases can be fought and won. It can also be won
in Africa, but only if the issue of rural poverty is addressed
head-on, and overcome.
Lennart Båge, President of IFAD | Q&A
with the President
HIV-AIDS is found almost everywhere, but principally in Africa.
In Africa it is found everywhere, but principally in the countryside.
It affects all classes, but principally the poor. As Director
Kiarostami observes in the film ABC Africa, HIV-AIDS is not transmitted
by mosquito bite: it is a social disease. The deadliest of all.
It is a complex disease, medically. It is a disease for which
there is no known cure - and for which existing treatments are
economically and organizationally beyond the reach of most of
those who suffer from it. Especially in Africa where hundreds
of millions of people live below the recognized ''lines''
of the most extreme poverty.
The social causes of the epidemic and its effects are much better
understood. As a social disease it reflects social conditions:
the fragility of rural economies and the lack of social power
of women. It reflects the high levels of migration of men, impelled
by the crisis of agriculture and rural development. It reflects
the spread of prostitution as a means of survival. And it reflects
the fact that it is poor women in rural society who have the least
social power to control their own sexuality.
The social consequences of HIV-AIDS are also well understood.
For those who directly suffer from it - and from the much greater
number who do not suffer from it, but whose lives are taking new
and more threatening shapes. Deepening rural poverty as families
sell their possessions and their tools to care for the sick and
compensate for lost income. Disorganization of families. Intolerable
strains on families and communities. And a crisis in the care
and education of the young. The effects on the future development
of Africa and the fight against rural poverty are incalculable.
None of this is inevitable. While the race for better treatment
and, ultimately, cure continues, the epidemic can be reduced through
attacking some of the most important social bases of vulnerability:
the local and global crisis of the African peasant economy; the
position of women and girl children in rural society. Prevention
can work, and it can reduce the medical burden dramatically. Mitigation
can work. Communities and families can be effectively helped to
regain their strength to deal with the challenge of millions of
orphans and loss of the young and able-bodied. The answer to the
social challenge of HIV-AIDS in rural Africa is something that
can be based only in the initiative and optimism of Africans themselves.
That is what is shown in ABC Africa : a willingness to engage
and struggle. Among women, among children and among men. While
we spend billions on the medical solution we should also be thinking
about the social problem and the social solution. And about re-engaging
in assistance to social and economic development in rural Africa
- without which the prospects for improving the lives of the majority
of the poor and controlling HIV-AIDS continentally and globally
are dim, indeed.