U.S. HIV/Aids Program Blending Food Aid, Anti-Retroviral Therapy

Kathryn Mcconnellusinfo Staff Writer Washington, DC

The United States is combining nutritional assistance with anti-retroviral drug therapy to boost the effectiveness of HIV/AIDS prevention and treatment programs in developing countries, says Michele Maloney-Kitts, program director of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

A "complex interface exists between the prevalence of HIV infection and chronic food insecurity," Maloney-Kitts said April 17 at the International Food Aid Conference in Kansas City, Missouri.
Because AIDS is "a wasting disease," people with it have "increasing energy needs," she said.

Established in 2004, PEPFAR is a five-year, $15 billion commitment with a particular focus on the 15 countries that are among the world's most severely affected by HIV/AIDS. Also working in 100 other countries, PEPFAR is the largest public health initiative dedicated to a single disease undertaken by any nation.

PEPFAR partners with the U.S. Agency for International Development and the U.S. Department of Agriculture, which administer U.S. food aid programs, to provide food to groups in the targeted countries that are vulnerable to malnutrition, including children born to women infected with HIV, pregnant women, lactating mothers and children orphaned by AIDS, she said.

Children who are HIV-positive at birth are more likely to need enhanced nutrition because they often begin life underweight. Without proper nutrition, these children are more likely to have stunted growth and be susceptible to other infections, according to PEPFAR officials.

The agency also partners with the U.N. World Food Programme (WFP), which receives nearly half its resources from the United States, host country governments, foundations and nongovernmental organizations to help sick and vulnerable people receive life-saving nutrients.

One such partnership is with the Academic Model for the Prevention and Treatment of HIV (AMPATH), an initiative that emphasizes food and economic security in addition to anti-retroviral drugs for people affected by HIV in Kenya, said Maloney-Kitts.

With AMPATH, PEPFAR is working with the WFP and the Bill and Melinda Gates Foundation to provide food therapy based in health care centers for six months and counseling and cooking classes to HIV patients and their families. Once patients regain their strength, they are provided access to job training. AMPATH currently is treating 20,000 patients, Maloney-Kitts said.

NUTRITION "FIRST LINE OF DEFENSE" AGAINST AIDS

In Ethiopia, PEPFAR is providing logistical support to help get food, vitamin supplements and nutritional counseling to people affected by HIV/AIDS, she said.

"Nutrition is the first line of defense" against HIV/AIDS, John Powell, WFP deputy executive director, said at the conference.

He said undernourished people are more prone to contracting communicable disease because chronic hunger leads to a sense of hopelessness, which can lead to risky behavior.

Powell also said that drug treatments are less effective when taken on an empty stomach.

In addition, he said, sick people who do not have enough to eat might be less likely to take their medication because the drugs, when taken on an empty stomach, can make the patient feel sicker.

Powell urged donors to devote more AIDS funding to agricultural development programs.

He said spending on improved seeds, fertilizers and irrigation and clean water systems in areas heavily affected by HIV can help patients grow their own nutritious food and eventually rebuild their strength.

As of PEPFAR's most recent report in September 2006, a total of 822,000 people were receiving anti-retroviral drug treatment it supported, up from an estimated 50,000 that received the treatment when PEPFAR was first funded. Approximately 1 million people are expected to receive PEPFAR-supported treatment by late 2007, Maloney-Kitts said.