The challenge of HIV/AIDS: Where does agroforestry fit in? - World ...

Chapter 23: The challenge of HIV/AIDS183HIV/AIDS is a slow epidemic with slowimpacts. Impacts only start to be obviousat the population level years after a sharpincrease in prevalence rates (Villarreal2003). This time lag varies in duration,but large numbers of deaths can be expected5–10 years after the onset of PhaseII, depending on the level of nutrition ofthe population and other factors. Death isone of the main impacts, but before deathoccurs, the person suffers weakness anddecreased ability to work for about twoyears (again, depending on nutritional,medical and other factors). Impoverishmentis another effect, starting more or lessat the time of decreased work ability. Impactsat the population level that lag someyears behind the death curve include theproblems faced by children who have lostfirst one then both parents. These ‘doubleorphans’ face tremendous problems in securingboth short- and long-term learningand livelihoods. Hypothetical ‘prevalence’and ‘death’ curves are shown in Figure 2.The time lag between the peaks of prevalenceand impact means there may be littleHIV prevalence/deathsFigure 2. Prevalence and death curves: Window of opportunity.Source: Villarreal (2003).Window ofopportunityHigh HIV rates/low impactobservable impact on a population evenwhen prevalence rates are very high. Inaddition, low prevalence rates may occurat the same time as high levels of impactduring Phase IV. Policies, programmes andother initiatives designed to prevent thespread of HIV/AIDS and mitigate its effectsneed to take account of the stage of theepidemic (Topouzis 2001).Very importantly for agroforestry initiatives,the lag between rising prevalence andimpact creates a ‘window of opportunity’for specific interventions. For example, asdiscussed below, some of the proposedlabour-saving initiatives are initially labour-intensive, and only later will producelabour-saving benefits. If they aresuccessful, the people could begin to reapthe advantages of such techniques whentheir need is greatest. Analysis of the progressionof AIDS at the household levelalso shows a time lag between the timeof infection of the first adult and the developmentof full-blown AIDS. Householdsgo through similar stages of prevalenceand impact and the death of differentPhase 1 Phase II Phase III Phase IVTimeDeathsPrevalencefamily members has different effects on thehousehold.Recent studies have shown that the preciseeffects of HIV/AIDS depend upon: a)the previous demographic structure of thehousehold; b) who and how many peoplein the household are chronically ill or die;c) the length of time that the household hashad to cope with the effects of the epidemic;and d) the resources the household hadat its disposal for dealing with increaseddemands (Mushati et al. 2003; Yamano andJayne 2004).Figure 3 depicts the different compositionof households affected by AIDS over time.There are 13 different types of householdsthat may exist in an area of high HIV/AIDSprevalence. In many communities, all13 types may exist at the same time. Eachtype of household has distinct resources,challenges and needs.Agroforestry possibilities forthe mitigation of HIV/AIDSimpactsIn this chapter we will be using a landscapeperspective on agroforestry: “Agroforestryrefers to a dynamic, ecologicallybased natural resources managementsystem that, through integration of treesin farms and in the landscape, diversifiesand sustains production for increasedsocial, economic and environmentalbenefits of land use at all levels,” (Leakey1996).Agroforestry can play an extremely importantrole in ensuring rural livelihoods survivean epidemic of HIV/AIDS because it:• enhances food security through improvingsoil fertility;• produces nutritious foodstuffs (fruits,berries, leaves) that can boost the