TOPSHOT – A member of the Turkana people carries farming tools on her way to her sorghum crops in an … [+] arid area in Nanyee, near Lodwar, Turkana County, Kenya, on October 1, 2019. – Turkana is a vast, dry area in the north-west of Kenya that is on the frontline of climate change. With regular searing temperatures the Turkana people are suffering from recurring and prolonged droughts. (Photo by Luis TATO / AFP) (Photo by LUIS TATO/AFP via Getty Images)
In 2015, leaders from 193 countries united in support of an ambitious plan to end world hunger and malnutrition by 2030. The “Zero Hunger” commitment was one of 17 bold pledges that comprise the Sustainable Development Goals (SDGs). But experts warn that laudable objective is now in jeopardy.
A recent World Health Organization (WHO) report revealed that without more leadership, by 2030 millions of people—especially in low- and middle-income countries—will face hunger and food insecurity which will lead to “long term health repercussions.”
Among the findings, Africa, which is home to roughly two-thirds of people living with HIV, is poised to surpass Asia as the continent with the highest number of people facing hunger by 2030. Given the linkage between hunger and health, here’s what this could mean for the AIDS fight.
The Nexus Of Hunger & Health
An estimated 713-757 million people may have faced hunger in 2023, according to the report. Nearly 300 million of these individuals reside in Africa where one in five people lack adequate nutritious food. By 2030, the WHO projects 582 million people will be chronically undernourished and more than half (53%) of them will live in Africa.
For years, scholars have tracked the connection between hunger and HIV. In 2009, Dr. Sheri Weiser, a professor at UC San Francisco and several peers published a report that found a clear nexus between hunger and HIV/AIDS. “Food insecurity and HIV/AIDS are intertwined in a vicious cycle that heightens the vulnerability to, and worsens the severity of, each condition,” the report concluded.
As hunger rises in Africa, experts fear increased HIV rates could follow. Desperation can cause people to engage in risky behaviors like transactional sex, putting them—and their partners—at heightened risk of acquiring or spreading HIV. Hunger can adversely impact antiretroviral treatment adherence and prevent people from seeking HIV testing as those individuals struggle to survive. One study found roughly one-third of people enrolled in HIV care programs across several western Kenya healthcare clinics were food insecure.
Conflict & Climate Change
Addressing the hunger crisis in Africa requires an understanding of its two biggest drivers, both of which are man-made.
Conflict both abroad and at home continues to plague Africa’s food security. Ukraine is well known as “Europe’s breadbasket,” but Africa also relies on the country. In 2020, fifteen African countries imported nearly half of their wheat from Ukraine and Russia. Following Russia’s unprovoked invasion, Ukraine’s grain production dropped by 29 percent. Closer to home, the underreported conflict in Sudan has caused cereal production to decline by nearly half. Conflict in neighboring Ethiopia has had similar detrimental impacts. One study found the country lost 543 square kilometers or roughly 8% of its most optimal cropland between 2015-2019. Meanwhile, years of conflict in Northern Mozambique have destroyed farmland and created mass migration, hindering access to antiretroviral treatment.
“Violence is having a significant impact on the mental health of all families touched by this conflict. Still, people living with HIV can experience even more stress and anxiety as accessing medication and healthcare is critical for them,” said Phillomina Kuvheya, a medical coordinator for Médecins Sans Frontières in Mozambique.
Beyond conflict, the climate crisis continues to impact those who have contributed the least to its causes—and they are many of the populations that have the highest HIV rates. In Africa, the agricultural sector accounts for roughly half of all employment. Nearly 70% of the continent’s food supply comes from 33 million smallholder farms. Many of these farmers lack the money for fertilizer or irrigation. Instead, they squeeze as much yield as they can from their small parcels of land—a task that has only become harder with rising temperatures and unpredictable weather patterns.
“First came the conflict, then the drought,” Kalayu, a 70-year-old farmer from Tigray, told CARE earlier this year. “The conflict took all my resources. All my goats and sheep were lost. They were the source of our happiness and immediate income. We relied on their milk for nutrition.”
The threats of conflict and climate on food insecurity are deeply concerning, but innovation is producing some hopeful solutions to ease the suffering. Drought-resistant seeds that increase crop yields may sound like science fiction meets Jack and the Beanstalk, but they have the potential to feed the future. Hybrid maize seeds have already shown enormous potential to increase grain yields by up to two-thirds per acre.
It’s important to remember that reliable access to food itself doesn’t prevent malnutrition. A groundbreaking study by Dr. Jeffrey Gordon from the Washington University School of Medicine demonstrated the important role that gut microbes play in malnutrition. New breakthroughs that improve microbiomes in babies could play a significant role in reducing malnutrition long-term. Not only would this lower the child death rate, but also put these infants on a better path to a thriving life absent HIV.
Why It Matters
As man-made crises place further strains on Africa’s food security, leaders will be forced to rethink how the world fights connected crises like HIV/AIDS. Nutritional needs will keep playing a larger role in holistic HIV prevention and care strategies. And more resources will be needed from governments, the private sector, and philanthropy to address the world’s abundant challenges.
There’s currently no clear picture for fixing the food security and nutrition financing gap, according to the WHO report. While achieving the “Zero Hunger” goal would likely require billions in new financial commitments, experts say the cost of inaction is even greater. According to the WHO, poor nutrition leading to poor productivity costs the world $3.5 trillion annually. Fixing this problem could be a real game changer—both for people’s lives and livelihoods.
“This is not just a blip, the global industrial food system is disastrously vulnerable to increasing climate, conflict and economic shocks – with climate crisis increasingly pounding farmers,” said Olivia De Schutter, the UN Special Rapporteur on extreme poverty and human rights. “Building climate-resilient food systems is now a life-or-death matter.”
