Webfeed
To fight Aids, drugs are not enough
Viewpoint
Wednesday August 13th 2008
We need to get on to "next generation" thinking and regard nutrition as just as important as drugs in treating illness, says Princess Haya Bint Al Hussein, a United Nations Messenger of Peace and former goodwill ambassador for the World Food Programme
Wednesday August 13th 2008
The Concern feeding centre in Kasongo, DRC Congo. Photograph: Jeffrey Barbee
I wish that all the Aids experts and politicians who gathered in Mexico City last week could have been with me two years ago when I met a young man in a nameless, dusty village in Malawi. It was easily the most memorable encounter of my life – royalty, heads of state, and celebrities included. The man was in his mid-30s and badly emaciated. His eyes were pink at the edges and I remember thinking they were somehow on fire with rage.
But there was really no anger in him – just exhaustion, anguish, confusion. After gently pushing ahead of the others in the crowd, he asked: "Why are you keeping me alive? Why give me these Aids medicines? I am too hungry and weak to work and care for my family. Why torture me this way?"
Needless to say these were not questions I expected. My hosts had a well-scripted visit to a field project prepared for their new Goodwill Ambassador to generate publicity. No one was prepared for this man or the depth of his pain. It seemed so odd that one of the few Africans fortunate enough to receive the expensive anti-retroviral drugs that hold Aids at bay would complain so bitterly. But we in the donor community had unwittingly given him a humiliating life no longer worth living.
What could I do? I assured him we would get him food and later the government of Dubai contributed to the World Food Programme's operations in Malawi to help families like his. I like to think he is now working and taking care of his family with some sense of dignity. But how could donors have missed something so basic as food in the battle against Aids?
Tens of billions of dollars have been pledged to combat the disease, yet donor countries have largely overlooked the role of nutrition, somehow managing to ignore both the scientists and the beneficiaries. The donors have been asked for help often enough and there are UN and NGO projects out there to fund, but they are not getting the cash they need to provide good, nutritious food to increasingly desperate people like the man I met in Malawi.
For a while it was the fashion in the aid community to speak about "participatory development", in which projects were planned based on the wishes of their intended beneficiaries. But over time this has proven to be more rhetoric than reality and the treatment of communities suffering from Aids offers perfect examples of how we simply fail to listen. Peter Piot, executive director of UNAids, was stunned that when he first met families devastated by the disease they did not ask for medicine or money, but food.
With the steep climb in cereals prices worldwide, the situation grows worse. There is no better evidence that something is amiss than articles in Nairobi's newspapers reporting that people being treated for HIV have been selling their anti-retroviral drugs to buy food for their children, and that began even before Kenya was racked with alarming food shortages this year.
The obliviousness of donors to the role of nutrition in treating and coping with disease exists beyond Africa and Aids. Last year a food assistance project in Cambodia ground to a halt for lack of donations. Many of its beneficiaries suffered from tuberculosis. Ensuring food security and proper nutrition has long been recognised as a critical component in treating tuberculosis. A monthly food ration draws TB patients in for their drug treatment and medical monitoring and helps build their strength to overcome the disease. My husband, Sheikh Mohammed, donated $1m for food to restart the project and donations came in from the US and Spain. Worried by the situation in Cambodia, the Lancet later ran an editorial on the growing danger of drug-resistant tuberculosis and how crucial it is to keep TB patients properly fed so they do not become poorly nourished "incubators" for a deadly disease that threatens us all.
There are some organisations engaged in what I call "next generation" thinking – principally Médecins sans Frontièrs (MSF). They have begun to promote food itself as necessary for healing and not just for those affected by Aids or TB. MSF is beginning to see special nutritious foods as medicine and that is an exciting development. After all, hunger and malnutrition remain the leading cause of death worldwide (according to the World Health Organisation, 2002), including the loss of 3 million children a year, and they undermine all our efforts to reach the UN Millennium Development Goals.
Sadly the aid community is slow in adopting the innovative thinking at MSF. Even traditional food aid has plummeted by 70% just since 1999 – the lowest level since the founding of the World Food Programme in the early 1960s. The chances that the special nutritional needs of people living with HIV and TB will be met grow slimmer. Adults with HIV infection require 10% more energy and, as the disease progresses, that need rises to 20-50%. Micronutrient deficiencies often plague HIV-infected adults and children, and they can be ended only with diversified diets, fortified foods or supplements. As food prices soar worldwide, poor families are already substituting less nutritious foods for higher-priced meat, fish, eggs and vegetables. For people who are already sick this can have drastic health consequences. The poorest families are being forced to choose between food and medicine for loved ones.
If we do not do a better job of helping poor HIV-affected families today, what chance will the next generation have for health and prosperity? It is time to change the way we help. Drugs alone are not a solution for Aids or TB. What doctor would admit patients to a hospital, give them the most advanced medications – and then leave them to starve?
Submit article to the following: 
|
del.icio.us
|
Newsvine
