Inter Press Service - October 14, 2007
Marwaan Macan-Markar

HIV (human immunodeficiency virus) is a retrovirus that can cause AIDS (acquired immunodeficiency syndrome), a condition which leaves infected human beings vulnerable to opportunistic infections.

There are some countries in South and South-east Asia that are aware about the link between AIDS and nutrition, but "there are no formal plans at the national level," says Randa Saadeh, a scientist in the nutrition for health and development division of the World Health Organisation (WHO). "What is done is on a scattered basis."

"If we don't include nutrition in our responses, we will be missing something in our care," Saadeh explained to IPS at the end of a week-long meeting held here to drum up support for a regional drive that aims to have concrete measures in place by 2009. "This is the first time that this region is being targeted. We want governments to adopt strong positions on this link as a solution," she said.

The absence of such policies has more to do with "the lack of awareness about the critical relationship between HIV (and AIDS) and nutrition," says Nigel Rollins, a professor of maternal and child health at the University of Kwazulu-Natal, in South Africa. "In Africa, it took 20 years for people to wake up to this link," the delegate said.

Strong nutrition programmes are vital for HIV and AIDS initiatives that range from prevention, mother-to-child transmission to care for those taking anti-AIDS drugs. "Traditionally, the population that faced food insecurity was also the ones who were vulnerable to HIV," Rollins told IPS. "Being malnourished has an impact on your immune system, making you more susceptible to disease like malaria or HIV."

This WHO-led campaign in Asia follows the initial drive to generate change in Sub-Saharan Africa, a region that is the epicentre of the AIDS epidemic. The African campaign was launched following a resolution approved at the 2006 World Health Assembly at the WHO's headquarters in Geneva.

That resolution formally recognised the link between nutrition, HIV and AIDS. It urged governments to "make nutrition an integral part of their response to HIV/AIDS by identifying nutrition interventions for immediate integration into HIV/AIDS programmes".

Studies of the four million people living with HIV and AIDS in this region in 2006 revealed that lack of nutrition was a problem for many, the WHO stated in a background note. "High malnutrition rates persist in the region and food is often identified as the most immediate and critical need by people living with HIV and others affected by the epidemic."

According to the global health body, the complex relationship between Nutrition, HIV and AIDS is reflected in the unique energy needs of people living with the killer disease. "Evidence has established that people living with HIV have higher energy needs than those who are not. Asymptomatic HIV-positive adults or children need 10 percent more energy than those who are not HIV-positive," it revealed. "Those at advanced stages need 20-30 percent more energy to maintain bodyweight. HIV-positive children who are losing weight need 50-100 percent more energy."

What is more, the lack of proper nutrition impairs the growth of children with HIV, adds the WHO. "Opportunistic infections such as chronic diarrhoea place an additional demand on their energy and nutrient needs. Poor growth in children is directly correlated with the risk of mortality."

As vulnerable to insufficient nutrition are HIV-positive mothers, says the WHO, since they need to "maintain their nutritional status before and right through pregnancy and lactation."

In fact, participants at the Bangkok meeting -- which drew people living with HIV and AIDS, technical experts, donors and officials from U.N. agencies -- are also hoping that the campaign convinces the region about the greater merits of breast feeding over milk substitutes.

"Exclusive breastfeeding carries a lower risk of HIV transmission in the first months of life than mixed feeding, (which means) giving other liquids or foods in addition to breast milk," states a scientific review on the theme released by WHO. "Exclusive breastfeeding is recommended for HIV-infected women for the first six months of life unless replacement feeding is acceptable, feasible, affordable, sustainable and safe for them and their infants before that time."

Even those who are on anti-retroviral (ARV) drugs need to benefit from this link, says J.V.R. Prasada Rao, head of the Asia-Pacific division of the Joint United Nations Programme on HIV and AIDS (UNAIDS). "If people on ARVs lack proper nutrition, they may not be able to deal with the large amount of drugs their system has to cope with."

And if such people were poor, there is always a possibility that they "may sell the ARVs to buy food to meet their basic nutrition needs," Rao told IPS. "This will only compound the problem we face."

The new campaign in this region goes up against prevailing national policies that have isolated HIV programmes from nutrition initiatives. "At the moment, nutrition policies of governments do not address the HIV/AIDS concerns and the AIDS policies of governments have not factored in the nutrition issues," Rao explained. "They have to be addressed together, as one."

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