WFP World Food Programme

Zarah Ali (not her real name) remembers how things changed for the better. “In 2014, I received a loan of 40 000 Djiboutian francs (US$ 250) that I used to develop and improve my garment business. I was also trained in business entrepreneurship, including marketing and customer satisfaction. I import clothes from Dubai and Somaliland and earn a decent income that helps me support my 25-year-old son, my 16-year-old daughter in secondary school and my three-year-old adopted son. I am able to pay for my rent, electricity and water and have decent meals.”

Ms Ali’s loan came from an income-generation programme established by the World Food Programme in collaboration with the United Nations Development Programme, UNAIDS and the national network of people living with HIV in Djibouti (RNDP+). The programme supports the long-term empowerment of, and provides regular incomes to, women living with HIV in Djibouti City. It helps them to achieve financial security and have access to food and improves their access to health-care services. Income-generating activities such as those supported by the programme have a powerful potential to help people living with HIV adhere to antiretroviral therapy and optimize health outcomes. 

The loans, ranging from US$ 141 to US$ 438 per person, are for starting or building retail businesses. The beneficiaries, who are selected from among two networks of people living with HIV affiliated to RNDP+ (ARREY and Oui à la Vie – Yes to Life), also receive training on how to run their business. Government support in the form of favourable policies and legislation has been vital to the success of the programme. 

Dekah Mohammed (not her real name) now lives a fulfilling life after receiving help from the income-generation programme. Ms Mohammed, who lost her husband to AIDS, lives with six children. After she lost her job in the hospitality sector owing to her deteriorating health and to stigma and discrimination, she started her own clothing business and received a loan of 50 000 Djiboutian francs (US$ 313) to expand her business. The loan was repaid within 10 months. Her business has since expanded into furniture and electronics and she has recruited an employee. “I am no longer a desperate woman. I make enough to take care of my family and dependants,” she said. 

The programme has improved the quality of life of many Djiboutian women, allowing them to regain dignity and ensure their financial security. It empowers women and girls to protect themselves from HIV, make decisions about their health, live free from violence and be financially independent. 

Building on the belief that empowering women living with HIV and their households to be financially independent strengthens adherence to treatment and leads to more fulfilling and dignified lives, the programme contributes to the World Food Programme’s broader strategic contribution towards ending AIDS as a public health threat by 2030.

As for everyone, food security is vital for people living with HIV. Access to food improves adherence to HIV treatment and lack of sufficient food can increase the risk of HIV infection through increased transactional, survival and intergenerational sex. And malnourishment affects how well HIV treatment works—people living with HIV who are malnourished are two to six times more likely to die in the first six months of treatment than those who are not.

For people living with HIV in eastern Ukraine, the conflict has had a significant impact on their food security, with most people living with HIV severely food insecure and living in extreme poverty. The conflict has displaced many people—especially women and children—HIV services have had to be relocated and the quality of services in many facilities is poor.

To prevent the collapse of HIV services and to increase food security for people living with HIV, civil society organizations and the United Nations have stepped in. In the parts of eastern Ukraine not controlled by the government, the United Nations and a few humanitarian organizations are the only entities making antiretroviral therapy and other medicines available.

The World Food Programme (WFP), a UNAIDS Cosponsor, is assisting thousands of people living with HIV in the conflict-affected areas with food support through a programme with the All Ukrainian Network of People Living with HIV, a nongovernmental partner of WFP. In the government controlled areas of Donetsk and Luhansk, 6500 people living with HIV are in a cash-based transfer programme to provide money for essential food. The assistance, which includes regular medical appointments and the monitoring of adherence to HIV treatment, has led to a fourfold decrease in treatment interruptions. In areas of eastern Ukraine not controlled by the government, in-kind food assistance has helped thousands to meet their basic needs.

The need for food support among people living with HIV in eastern Ukraine is, however, far outstripped by the resources available to support them. Although 6500 people living with HIV in Donetsk and Luhansk are accessing cash-based transfers, thousands more are not being assisted, and the need is even greater in the areas beyond government control. There are fears that even this limited help may have to end, since WFP has yet to receive funds to continue the programme in 2018.

GENEVA, 31 March 2017—UNAIDS welcomes the appointment of David Beasley as the Executive Director of the World Food Programme (WFP).

“The appointment of David Beasley comes at a critical moment,” said UNAIDS Executive Director Michel Sidibé. “WFP’s work to achieve food security is at the heart of global efforts to break the cycle of hunger and poverty and essential to achieving the Sustainable Development Goals which include ending the AIDS epidemic.”

WFP has recently reported that more than 100 million people are facing severe food insecurity around the world and 20 million people in four countries (South Sudan, Somalia, Nigeria and Yemen) are currently facing famine.

During humanitarian crises, access to health care services and availability of medicines for people living with HIV are disrupted, and people find it hard to meet their nutritional needs, further risking their health.

WFP, a UNAIDS Cosponsor, works to integrate food and nutrition within the comprehensive care, treatment and support package for people living with HIV and/or active tuberculosis (TB). WFP also works with the Office of the United Nations High Commissioner for Refugees to ensure that food security and related needs are adequately addressed among displaced, refugee and returnee populations. Together they support HIV and TB prevention and care, as well as food and nutrition assistance activities in humanitarian emergencies.

Integrating food and nutrition components in HIV and TB treatment and support packages is critical to ensuring better health outcomes for people living HIV and/or TB. In 2015, WFP’s HIV and TB programmes reached 540 000 people.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

AIDS strategies and efforts must give greater priority to humanitarian emergencies and the millions of people affected by them, members of the UNAIDS governing body agreed at the thematic segment of the 36th meeting of the UNAIDS Programme Coordinating Board (PCB), which took place in Geneva, Switzerland, on 2 July.

New data presented at the thematic session by the Office of the United Nations High Commissioner for Refugees (UNHCR), the World Food Programme (WFP) and UNAIDS Secretariat estimate that of the 314 million people affected by humanitarian emergencies in 2013, 1.6 million people--or 1 in 22-- are living with HIV, and many thousands more are at risk.

“We are talking about incredible numbers of people and multiple layers of vulnerability. This is too big a scale and impact to ignore. We have to ensure that HIV prevention and treatment services are systematically integrated into emergency responses,” said Mr Michel Sidibé, Executive Director of UNAIDS.

The thematic session contemplated the vast and complex issue of HIV in emergency contexts, including the delivery of health and HIV services in the context of conflict situations, natural disasters, public health emergencies, displacement and migration. On protection issues, vulnerability to HIV due to sexual violence, human rights violations, restrictions, punitive laws and policies were topics of discussion. On resilience, participants talked about the need for community building and preparedness.

Panelists from a wide range of countries including Burundi, Central African Republic, Djibouti, Haiti, Lebanon, Liberia, Nepal, Nigeria, Sierra Leone and Ukraine told of the realities on the ground. They spoke of barriers and opportunities and gave examples of successful government and civil society efforts to address HIV in the wide variety of humanitarian emergency contexts.

In his keynote speech, former refugee Mr Noé Seisaba from Burundi, who founded the Stop SIDA organization that brings key HIV initiatives to refugee camps and settings, called for the community of people living with HIV to be involved in all aspects of planning and implementation. “I faced a lot of discrimination, but I broke my silence on HIV to try to make working on HIV a community issue and to show that we can intervene as refugees because we have a true understanding of the challenges and realities,” he said. “I am happy to see we are all talking about this issue, but I want to see concrete action.”

Many participants echoed that community involvement and empowerment of people living with and most affected by HIV are critical to achieve results for people in such difficult contexts. “If we are going to end the AIDS epidemic by 2030, we have to shine light on root causes of vulnerability in humanitarian settings and increase action to promote respect for rights and basic humanitarian dignity,” said Mr George Okoth-Obbo, Assistant High Commissioner for Operations at UNHCR.

Cross-regional strategies were encouraged to enable maximum impact and coverage of people. The challenge of sexual violence in emergency settings and gender inequalities was highlighted as a fundamental issue to be given greater focus, action and investment.