Emergency relief in high HIV prevalence area
De Waal A, Whiteside A. New variant famine: AIDS and food crisis in
southern Africa. Lancet, 2003, 362(9391): 1234-1237.
The authors explain how the new variant food crisis would occur according to
HIV/AIDS, drought and mismanagement. This new variant famine in southern African
societies would be the first major manifestation of a chain reaction of further
famines, epidemics or even massive out-migrations. Because of HIV/AIDS, the
authors claim that the impact of a drought, for example, would be much more
deleterious than past ones, and the consequences would be felt for a much longer
time. The authors have used frameworks drawn from famine theory to examine the
implications of the HIV/AIDS epidemic and to support their theory. Thus,
HIV/AIDS has created a new category of high vulnerable household, and four
factors have been identified and explain the grim trajectory of recovery:
vicious interactions between malnutrition and HIV, the burden of care, loss of
assets and skills, and decline of food production. The article ends with a call
for long-term international efforts to deal with humanitarian needs in southern
Africa.
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ENN. Targeting Food Aid in Emergencies. Special Supplement Series, No 1,
July 2004. Emergency Nutrition Network, Oxford, 2004.
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the entire article.
ENN, IBFAN, Terre des hommes, UNICEF, UNHCR, WHO, WFP. Infant Feeding in
Emergencies for health and nutrition workers in emergency situations. Module 2,
Version 1.0, Emergency Nutrition Network, Oxford, 2004.
This document is the second of two Interagency Working Group Modules on
Infant Feeding in Emergencies. This module covers breastfeeding and artificial
feeding in natural disasters, complex emergencies, and large-scale population
displacements. It provides health and nutrition workers with basic knowledge
and skills to help both breastfeeding and artificial feeding women. The module
aims to restore the feeding that is the most appropriate for infant and young
child in emergency settings. First, it provides ways for women to not loose
confidence and introduce artificial feeds unnecessarily, then it proposes
tools to identify and help women who have difficulties feeding. The document
does not focus specifically on HIV/AIDS in emergency setting, but provides
section on the topic.
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for the entire article.
Harvey P. HIV/AIDS and humanitarian action. London, Humanitarian Policy
Group, Overseas Development Institute, 2004.
This complete report examines the implication of HIV/AIDS for our
understanding of crisis and the role of humanitarian aid. The report focuses on
the humanitarian response, to the drought, in southern Africa in 2002 and 2003.
It exposes an assessment of the particular, and new, situation brought by
HIV/AIDS in the humanitarian aid perspective. It sketches some of the key
dimensions and characteristics of the HIV/AIDS epidemic and reviews the growing
literature on how HIV/AIDS impacts upon livelihoods, including food security and
water safety. It considers both what this literature can tell us, and the gaps
that remain. It explains how the existing models of humanitarian aid,
constructed around the idea of short-term response to acute need, may not be an
appropriate instrument for responding to a long-term crisis as HIV/AIDS. The
ways in which humanitarian programming may or may not need to be altered in the
context of the HIV/AIDS epidemic is also approached. The report ends with a
summary of the implications of the HIV/AIDS for humanitarian action.
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entire article.
IASC. Guidelines for HIV/AIDS interventions in emergency settings.
Inter-Agency Standing Committee 2003.
The aim of this guideline is to help individuals and organizations in their
effort to address the special needs of HIV-infected and HIV-affected people
living in emergency situations. On the 26 actions sheets, 6 provide informations
on nutrition, HIV/AIDS and emergencies, those are the following: 1) Target food
aid to affected households and communities; 2) Include HIV considerations in
water/sanitation planning; 3) Promote appropriate care and feeding practices for
people living with HIV/AIDS; 4) Support and protect food security of HIV/AIDS
affected and at risk households and communities; 5) Distribute food aid to
affected households and communities; and 6) Plan nutrition and food needs for
populations with high HIV prevalence. This document provides also key resources
linked to the 26 actions sheets.
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Leyenaar J. Human immuno-deficiency virus and infant feeding in complex
humanitarian emergencies: priorities and policy considerations. Disasters, 2004,
28(1):1-15.
Mother-to-child transmission of HIV/AIDS pose considerable challenges in
complex humanitarian emergencies. The risk of vertical transmission through
breastfeeding is well recognized, but safe alternatives are limited by the
social, economic and environmental conditions of emergency situations. This
article outlines reasons why the recommendations drafted in 2000 by the WHO
Inter-agency Task Team on Mother-to-Child Transmission of HIV may be
insufficient during the initial stages of humanitarian emergencies. Methods of
mother-to-child transmission of HIV are reviewed and recent research findings
are discussed. Ethical limitations and future priorities are considered. The
paper concludes with recommendations and a policy decision-making framework for
consideration during the initial stages of humanitarian crises.
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Mason JB, Bailes A, Mason KE et al.
AIDS, drought, and child malnutrition in southern Africa. Public Health
Nutrition. 2005, 8(6): 551-563.
This epidemiological analysis aims to investigate trends in child
malnutrition in six countries in southern Africa in the context of HIV
epidemic and drought during years 2001-2003. Data from Lesotho, Malawi,
Mozambique, Swaziland, Zambia and Zimbabwe concerning weight-for-age of
children 0-5 years and HIV prevalence were collected, analysed and
recommendations given. Importantly, the most vulnerable may no longer be in
the rural areas, but it occurs that the semi-urban households may be the most
vulnerable and to whom resources need to be directed. The causes of this
vulnerability need further investigations. HIV/AIDS interacts with drought and
amplifies the effects of malnutrition, so in case of other drought the
response needs to be rapid and effective. Therefore specific nutritional
surveillance is needed to monitor and respond to deteriorating trends. Even in
normal years HIV epidemic leads to deterioration in child nutrition and
well-being. The authors call for new means of bringing help, comfort and
assistance to the child population.
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Murphy LL. HIV/AIDS and humanitarian action insights from US and Kenya
based agencies. London, Overseas Development Institute, 2004.
This document highlights key themes that emerged in discussions about the
implications of HIV/AIDS for humanitarian action. It defends the point of view
that HIV/AIDS is a long term emergency. HIV/AIDS implies enormous practical,
financial, institutional, technical and ethical challenges to meeting the goal
of providing appropriate relief during a long-term crisis. Experiences are
emerging, and many new questions arise for this new and certainly unprecedented
pandemic. This document presents concerns and experiences of humanitarian
agencies that have been on the field either during the Southern African crisis
of 2002-03, or on the field in East Africa. The findings of this paper intend to
facilitate fruitful discussion and debate at all levels within and across
humanitarian agencies, from field work to headquarters policymaking and donor
funding.
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entire article.
Salama P et al. Lessons learned from
complex emergencies over past decade. Lancet, 2004, 364:1801–13.
This article summarizes the major advances that have been made over past
decade in the field of complex emergencies. It does not focus on nutrition and
HIV/AIDS, but presents a relevant history of different indicators used to
address complex emergencies. It presents the key development in epidemiology and
assessment tools that have been developed to estimate the gravity of complex
emergencies. The experiences of complex emergencies from the last 14 years is
reviewed. The authors then propose new directions for different topics of
research for technical issues, nutrition and food security, and communicable
diseases. This last topic briefly discusses the ignored impact of HIV/AIDS in
past complex emergencies, and therefore makes some propositions. Due to the
changing nature and focus of complex emergencies into wider and longer
conflicts, there is a need for profound shifts in approaches. The authors
propose, to improve outcomes and to broaden and reinforce the skills of
professionals working in complex crisis settings. They also suggests to modify
the curriculum of short-courses and master's degrees into a more practical and
analytical approach.
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NEW! UNAIDS, UNHCR, WFP. The development of
programme strategies for integration of HIV, food and nutrition activities in
refugee settings. Geneva and Rome, Joint United Nations Programme on HIV/AIDS,
United Nations High Commissioner for Refugees and World Food Programme, 2007.
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UNHCR. Integration of HIV/AIDS activities with food and nutrition support
in refugee settings: specific programme strategies. Geneva, United Nations High
Commissioner for Refugees, 2004.
This paper provides practical guidance on the integration of food and
nutrition programmes with support activities for people with HIV/AIDS among
refugees. The guidelines are also applicable to host communities and other
populations affected by emergencies. It is known that food insecurity, poor
nutrition and the incidence and severity of HIV infection are intimately
associated. It describes two types of integrated programme strategies:
1-HIV/AIDS prevention, care, treatment and support activities into food and
nutrition programmes, and 2-food and nutrition training, or use food resources
for capacity-building and/or institutional support activities, in HIV/AIDS
programmes. It provides an overview of 20 specific opportunities for more
effective, collaborative and innovative integration of HIV/AIDS activities with
food and nutrition support in refugee settings. These integrated programme
strategies are presented in 20 summary action sheets. This document is intended
to evolve through lesson learned.
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Young H et al. Public nutrition in complex emergencies. Lancet, 2004,
364(9448):1899-1909.
Public nutrition is a multifaceted problem-solving approach to addressing
malnutrition in complex emergencies. This article focuses on six broad areas: 1)
nutritional assessment and surveys, 2) meeting food needs through general food
distribution, 3) management of moderate malnutrition, 4) management of severe
acute malnutrition, 5) prevention and treatment of micronutrient deficiency
diseases, and 6) nutritional needs of at risk groups, including people living
with HIV. The article ends with future research advices. Although major advances
in the field of public nutrition have been made in complex emergencies,
important research remain. The multisectoral nature of public nutrition implies
a strong coordination between all actors, including government, academic
institutions, and UN agencies.
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