HIV/AIDS, Nutrition, and Food Security: Looking to Future Challenges

The Challenge of ARV Rollout Rollout of antiretroviral (ARV) therapy under the aegis of the WHO's " 3 by 5 " initiative , with funding from numerous donors via the Global Fund for TB, HIV/ AIDS, and malaria, the U.S. PEPFAR and U.K. DFID, gives cause for hope for all those millions of people in Africa who are living with HIV/AIDS. Midway through 2005 nobody seriously believed that the target of 3 million people on treatment by year end would be achieved. However, it was a necessary goal at that stage. But for those concerned with meeting the challenge of HIV/AIDS impacts, increased antiretroviral therapy (ART) availability has to be seen for what it is: an opportunity to take a breath in the struggle against the impact of AIDS and think, and think hard, about what we do next. The last 20 years have not shown any great success in confronting the impact of HIV/AIDS on nutrition and food security. Although this problem was identified as early as 1988 (Abel et al. 1988; Gillespie 1989) and explored through field research in 1989 (Barnett and Blaikie 1990), most if not all of the response has been to roll out policies that have been tried and tested in other, non-AIDS, situations , to try to apply existing " installed capacity, " whether ideas, techniques, or institutions, rather than to recognize the specific nature of HIV/AIDS impact and respond to that. To use solutions to yesterday's problems to confront the new problems of today and tomorrow is to invite failure. This is even more the case in a world with ART. ART offers us a window of opportunity in which we must work hard to come up with new solutions appropriate to the new situation.