The Impact of HIV and AIDS on Agriculture and Food Security in Lesotho. Thope A. Matobo Makhala B. Khoeli Regina M.Mpemi

Transcription

1 FANRPAN Working Document: Series Ref. Number: NAT LES006 The Impact of HIV and AIDS on Agriculture and Food Security in Lesotho 2006 Prepared for FANRPAN by: Thope A. Matobo Makhala B. Khoeli Regina M.Mpemi. National University of Lesotho P.O. Roma 180, Lesotho i

2 Disclaimer The views expressed in this Report are those of the author(s) and not necessarily endorsed by or representative of FANRPAN or of the cosponsoring or supporting organization ii

3 TABLE OF CONTENTS CHAPTER ONE: Study Background Introduction HIV and AIDS Situation in Lesotho Status of Agriculture and food security in Lesotho Livestock Production in Lesotho Crop production in Lesotho The Study Problem Study Objectives Study hypotheses Study Rationale Conceptual framework Food Security 10 CHAPTER TWO: Review of Literature Introduction HIV and AIDS and the Work Force HIV and AIDS impact on Agriculture and Food Security Labour Quality and Quantity Dependency Ratio Vulnerability. 22 CHAPTER THREE: Methodology Methods of data collection Study Sites Sampling procedure Study limitations.. 26 CHAPTER FOUR: Presentation of Findings Introduction Household Description Households Characteristics Farmer Type Household Asset Composition Household Domestic Assets Households Assets for Agriculture Impact of HIV and AIDS on Household Assets Safety Nets and Social Capital Stocks Household Labour and HIV and AIDS Agricultural Production and HIV and AIDS Introduction HIV and AIDS, and Crop Production Arable Land and HIV and AIDS Households Decision Making on Crop Production Area planted for Households Households Crop Yield 46 iii

4 4.3.7 Contribution of Infected Member(s) on Crop Production Marketing of Crops Produced by Households HIV and AIDS and Livestock Production Households Decision Making on Livestock up Keeping Livestock Ownership by Households Impact and Contribution of Infected Member(s) on Livestock Rearing Marketing of Livestock and Livestock Products Variable Costs of Agriculture Production Income Received from Crop and Livestock Production Affected Households Responses to HIV and AIDS Introduction Household Members Living with or Died of HIV and AIDS Related Illnesses Location of HIV-Infected Persons Before And During Illness The Source of Income for the Patient Caring of HIV-infected Persons Households Responses and Strategies to Having an HIV-Infected Household Decision Making Regarding Food intake and Dietary Adjustments Dietary Adjustment by the Infected Member Dietary Adjustment by the Caregiver Dietary Adjustment by the affected Head of Household Dietary Adjustment by the Affected Adult of 18 Years and above Dietary Adjustment by the Affected Children Aged Below 18 Years Food Foregone by the Household Members HIV and AIDS-related Orphans Household Income Expenditure Expenditure on crop production Expenditure on Household Assets Expenditure on household food Hospital bills for the infected Household expenditure on transport for the infected Burial expenses Coverage of households with HIV infected members Households Consumption Expenditure Household Direct Consumption Expenditure Household Investment Expenditure 76 CHAPTER FIVE: Measuring Households Vulnerability Computing the Household Vulnerability Index (HVI) Households Vulnerability Under Human Capital Dimension Household Vulnerability Under Financial Capital Dimension Household Vulnerability Under Social Capital Dimension Household Vulnerability Under Physical Capital Dimension Household Vulnerability Under Natural Capital Dimension Household Vulnerability Under Food Production Capital Dimension 83 iv

5 5.8 Households Vulnerability Under Different Levels Of The Overall Households Vulnerability 85 CHAPTER S IX: Discussion of Results Family size and composition Capital stocks Farm household production decisions Household Food and Nutrition Security Safety Nets Household Consumption and Income Expenditure Conclusions 93 CHAPTER SEVEN: Policy Implications Introduction Improvements and Introduction of New Agricultural Technology Eradication of famine and Poverty Empowering Women and Redressing Gender Inequality Supervision and Education of communities by Agricultural Extension Workers Strengthening Household Coping Capacity 98 BIBLIOGRAPHY. 98 APPENDICES 98 v

6 ACRONYMS AND ABBREVIATIONS AIDS CHAL EU FANR FANRPAN FAO FPE HIV H.S.A HVI ISAS MOHSW NGO NUL PHC SADC SAFAIDS UNAIDS UNICEF USAID WFP Acquired Immune-Deficiency Syndrome Christian Health Association of Lesotho European Union Food, Agriculture and Natural Resources Food, Agriculture and Natural Resources Policy Analysis Network Food and Agriculture Organization of the United Nations Free Primary Education Human Immuno-Virus Health Service Area Household Vulnerability Index Institute of Southern Africa Studies Ministry of Health and Social Welfare Non-Governmental Organization National University of Lesotho Primary Health Care Southern African Development Community Southern African AIDS Information Dissemination Service united Nations Joint Programme on AIDS United Nations Children s Fund United States Agency for International Development World Food Programme vi

7 LIST OF TABLES Table 1.1: Lesotho: Recent Economic Performance Table 1.2: HIV/AIDS Statistics in Lesotho Table 1.3: Reported new AIDS Cases in Lesotho by Age and Sex in 2000 Table 1.4: Lesotho: Livestock Numbers in 2000/2001 Table 1.5: Total Cereal Production ( 000 tonnes) in 2004/05 compared to five-year Average Table 1.6: Population density per square Km in Lesotho. Table 2.1: Projected Labour Force Loss with HIV/AIDS in 2005 and 2020 within SADC Table 2.2: Percentage losses in Agricultural labour force resulting from HIV/AIDS. Table 3.1: Health Service Area by District and Agro-ecological zone Table 3.2: Agro-ecological zones, Districts and Households Table 4.1.1: Relationship of Members with the Household Table 4.1.2: Education of Household Members Table 4.2.1: Households Field Assets for Agriculture Table 4.2.2: Households Garden Assets for Agriculture Table 4.2.3: Tasks for which households used hired labour Table 4.3.1: Household Total Arable Land at Home in Acres Table 4.3.2: Total Size of Fields Owned by Households in Hectares Table 4.3.3: Size of Land Cultivated by Households in Hectares Table 4.3.4: Challenges Faced in Cultivation Due to Illness Table 4.3.5: Coping Strategies Adopted in Cultivating Table 4.3.6: Decision Maker on Maize Grown Table Area Planted to Maize in Hectares Table : Yield of Maize in Kilograms Table : Contribution of infected Member(s) on Crop Production Table : Decision Making on Type of Livestock Households Kept Table : Decision Making on Variety of Livestock Households Keep Table : Decision Making on Number of Livestock Households Keep Table : Cows/heifers Owned by Households Table 4.4.1: Ages of Persons Who Were Performing Various Care Activities Table 4.4.2: Comparison of Food Eaten in the Morning by Affected Children Aged Below 18 Years Table 4.5.1: Source of Payment of Hospital Bills Table 4.5.2: Membership in Financial and Health Coverage Schemes Table 4.6.1: Respondents source of funds for purchasing consumer goods and services Table 4.6.2: Places where respondents went for Health Care Goods and Services Table 5.1: Households Vulnerability Levels for Social Capital Dimension Table 5.2: Households Vulnerability Levels for Natural Capital Dimension Table 6.1: Lesotho: Cereal Supply/Demand Balance 2005/06 (000tonnes) Table 6.2: Food deficit by livelihood zone List of Figures Figure 1.1: Flow Chart showing food security and its components Fig 2.1: Livelihood Rights Model Figure 4.1.1: Marital Status of Household Members vii

8 Figure 4.1.2: Employment Status of Household Members Figure 4.2.1: Time of Affiliation with the HIV and AIDS Community Club Figure 4.2.2: Reasons for Joining HIV and AIDS Community Club Figure 4.2.3: Type of Advices Given on Combating Figure 4.3.1: Difference on Ownership of Arable Land during the Survey Period Figure 4.3.2: Reasons for not Utilizing Arable Land Figure 4.3.4: The Way Illness Affected Ability of Households to Cultivate Figure 4.3.4: Impacts of HIV and AIDS on Ability to Cultivate Arable Land Figure 4.3.5: Decision Maker on Arable Land Before, During Illness and the Survey Period Figure : Direct Impact of the Infected Member(s) on Number of Livestock Figure 4.3.7: Contribution of the Infected Member(s) to Livestock Up Keeping Figure : Challenges Faced in Livestock Production Due to HIV and AIDS Figure 4.3.9: Coping Strategies Adopted by Households for Livestock Production Figure 4.4.1A: Status of Infected Members of the Household by Age Figure 4.4.1B: Status of Infected Household Member by Sex Figure 4.4.3A Persons Responsible For Making Decisions on Dietary Adjustments Figure 4.4.2: The Caring Activities by Gender Figure 4.4.3B: Food Eaten By the Infected Persons Before Illness Figure 4.4.3C: Source of Food for the Infected Person Before Illness Figure D: Food Eaten by the Infected Persons During Illness Figure 4.4.8A: Times of Meals Foregone by Affected Household Member(s) Figure 4.4.8B: Ages of Affected Household Members who had to Forego Meals Figure 4.4.8C: Gender of Household Members who Forgone Meals Figure 5.1: Households Vulnerability Levels for Human Capital Dimension Figure 5.2: Households Vulnerability Levels for Financial Capital Dimension Figure 5.3: Households Vulnerability Levels for Physical Capital Dimension Figure 5.4: Vulnerability Levels for Household Production for Food Capital Dimension Figure 5.5: Comparison of Households Vulnerability Levels for Different Dimensions APPENDICES Appendix A: Decision Making on Crop Production Table 4.3.7: Decision Maker on Sorghum Grown Table 4.3.8: Decision Maker on Beans Grown Table 4.3.9: Decision Maker on Vegetables Grown Table : Decision Maker on Potatoes Grown Table : Decision Maker on Pumpkin Grown Appendix B: Area Planted Table : Area Planted to Sorghum in Hectares Table : Area Planted to Beans in Hectares Table : Area Planted to Vegetables in Hectares Table : Area Planted to Pumpkin in Hectares Table : Area Planted to Potatoes in Hectares Appendix C: Crop Yield Table : Yield of Sorghum in Kilograms Table : Yield of Beans in Kilograms Table : Yield of Potatoes in Kilograms Table : Yield of Pumpkin in Kilograms Appendix D: Livestock Ownership viii

9 Table : Sheep Owned by Households Table : Pigs Owned by Households Table : Poultry Owned by Households CHARTS Figure 4.4.1C: Source of Income for the Infected Member of the Household Figure 4.4.2A: The Caring Activities and Persons Responsible for Them Figure 4.4.3E: Food Eaten By the Infected In the Morning Before And During Illness Figure 4.4.3F: Food Eaten By the Infected Persons in the Afternoon Before and During Illness Figure 4.4.4A: Food Eaten by the Caregiver Before Illness Figure 4.4.4B: Sources of for Food Eaten by the Caregiver Before Illness Figure 4.4.4C: Food Eaten By the Caregiver During Illness Figure 4.4.4D: Source of Food Eaten by the Caregiver During Illness Figure 4.4.4E: Food Eaten by the Caregiver During the Survey Period Figure 4.4.4F: The Source of Food Eaten by the Caregiver During the Survey Period Figure 4.4.5A: Food Eaten By the Affected Head of the Household Before Illness Figure 4.4.5B: Source of Food Eaten By the Affected Head of the Household Before Illness Figure 4.4.5C: Food Eaten by the Affected Household Head During Illness Figure 4.4.5D: Source of Food Eaten by the affected Household Head During Illness Figure 4.4.5E: Food Eaten by the affected Household Head During the Survey Period Figure 4.4.5F: Source of Food for the Affected Household Head During the Survey Period Figure 4.4.6A: Food Eaten by Affected Adult of 18 Years and Above Before Illness Figure 4.4.6B: Source of Food Eaten by Affected Adult Aged 18 and Above Years Before Illness Figure 4.4.6C: Food Eaten by Affected Adult Aged 18 Years and Above During Illness Figure 4.4.6D: Source of Food Eaten by Adult Aged 18 Years and above During Illness Figure 4.4.6E: Food Eaten by the Affected Adult Aged 18 Years and Above During the Survey Period Figure F: Source of Food Eaten by the Affected Adult Aged 18 Years and Above During the Survey Period Figure 4.4.6G: Family as Source of Food of the Affected Adult Aged 18 Years and above Figure 4.4.6H: Donations as Source of Food of the Affected Adults Aged 18 Years Above Figure 4.4.7A: Food Eaten By Affected Children Aged Below 18 Years Before Illness Figure 4.4.7B: Source of Food Eaten by Affected Children Aged Below 18 Years Before Illness Figure 4.4.7C: Food Eaten By Affected Children Aged Below 18 Years During Illness Figure D: Source of Food Eaten By Affected Children Aged Below 18 Years During Illness Figure 4.4.7E: Food Eaten By Affected Children Aged Below 18 Years During the Survey Period Figure 4.4.7F: Source of Food Eaten By Affected Children Aged Below 18 Years During the Survey Period Figure 4.4.7G: Family as Source of Food of the Affected Children Aged Below 18 Years Figure 4.4.7H: Donations as Source of Food for the Affected Children Aged Below 18 Years Appendix F: Qualitative Interview Reports of Caregivers Appendix G: Analysis of Orphans Appendix H: List of Participants ix

10 Foreword The study of HIV and AIDS impact on Agriculture and Food Security in Lesotho was a two-year project that began in The similar study has been conducted in the countries of Botswana, Swaziland, Namibia, South Africa, Zambia and Zimbabwe. The project has been funded by the European Union, through Food Agriculture and Natural Resources Policy Analysis Network [FANRPAN]. The National University of Lesotho hosted it under the directorate of the Institute of Southern African Studies [ISAS]. x

11 Acknowledgements The research team would like to express their gratitude to EU, FANRPAN and the National University of Lesotho for the institutional and financial support that made possible The study on the impact of HIV and AIDS on Agriculture and Food Security in Lesotho. We also would like to thank the staff of Roma, Maluti, Mokhotlong, and Quthing Health Service Areas for their continued support and facilitation that led us to the HIV and AIDS support groups as well as the affected and infected household members. Gratitude goes to the support groups themselves for their support. A heartfelt gratitude goes to those affected families that had to endure the questions from the research team and assistants. Our research assistants played a major role in this study. We thank them as well. Gratitude also goes to C. Chitereka, M. Bohloa and S. Sekoli for their contribution. We would like to thank all stakeholders, the Ministries and NGO s that participated in this study. There are other people who played different roles in this study who have not been mentioned by name who we are very grateful to. Mrs. L. Matsoso played a major role in the editing of the final report. Her contribution and comments have been valuable. xi

12 About the research Team The research team consisted of the following: Thope Matobo Project and node coordinator She is currently a senior lecturer in the Department of Social Anthropology, Sociology and Social Work at the National University of Lesotho. Before joining the university, she held a position of research officer in the Rural Sociology Section of the Agricultural Research Division of the Ministry of Agriculture in Lesotho from 1981 to Both her BA and MA degrees are in Sociology having completed them from the National University of Lesotho in 1981, and Washington State University in 1987, respectively. Her emphasis was on rural communities. She has in the past participated in research in agriculture, health, informal sector, labour migration and evaluation of large-scale projects in government and the private sector. Her training has exposed her to a wide range of research and consultancy projects. She has been a coordinator in several of those projects. She has published articles in journals. ta.matobo@nul.ls Makhala Khoeli Project Data Analyst She is a Lecturer in the Department of Statistics and Demography of the National University of Lesotho. She previously worked as a Statistician in the Agricultural Statistics Division of the Bureau of Statistics, Lesotho. She obtained a Masters in Statistics at the Institute of Statistics and Applied Economics (ISAE), Makerere University, Kampala, Uganda. She has been involved in various statistical consultancy activities Health and Social Welfare [MOHSW] and other organisations that include the Nedbank. mb.khoeli@nul.ls Regina Mamello Mpemi Project Health Specialist She is currently a Lecturer in the Faculty of Health Sciences at the National University of Lesotho. She has held positions of Nurse Educator and Principal at Roma College of Nursing. In addition, she has been a Community Health Nurse at one of the health centres in the country. She holds an MSc Nursing degree from the University of Zimbabwe and BSc Nursing from the University of Natal. She has studied Nursing Education, Midwifery and Neonatal care. She has basic skills in nutritional assessment, care and support of People Living with HIV and AIDS both at primary and tertiary settings. She has also been involved in HIV and AIDS related research. mmpemi@yahoo.co.uk xii

13 CHAPTER ONE Study Background 1.0 Introduction The HIV and AIDS scourge has been with us for over 20 years and it continues to challenge us globally. In the years since their discovery, HIV and AIDS have aroused more concern than any other health conditions from research and media coverage and yet the epidemic is still progressing and no cure has yet been found. Since the onset of HIV epidemic more than 60 million people have been infected with HIV. Although HIV and AIDS have now been identified in nearly all the countries, the prevalence or scale of infection varies widely both between and within countries. The virus reached the global regions at different times and has spread faster or slower in various populations, depending on different factors. In Sub-Saharan Africa - the worst affected region in the world, HIV/AIDS represents a severe development crisis. According to UNAIDS (2003), even if exceptionally effective prevention, treatment and care programmes take hold immediately, the scale of the epidemic means human and socio-economic toll will be massive for many generations. In Sub-Saharan Africa, over 29.4 million people are infected with HIV (8.8% adult prevalence), making the region the worst affected in the world, with an estimated 3.3 million new infections in It was further indicated that ten million young people (aged 15-24) and almost 3 million children under 15 years were living with HIV (UNAIDS, 2003). Of the 34 million children who were orphans in Sub-Saharan Africa, 1/3 of them lost their parents due to HIV and AIDS. In Southern Africa, seven countries: Botswana, Lesotho, Namibia, South Africa, Swaziland, Zambia and Zimbabwe are reported to have adult HIV prevalence of more than 30 percent. In these countries, life expectancy was projected to decline from 60 to 70 years to 30 to 40 years (Shapouri and Rosen, 2001). Thus, if the pandemic is not checked, population levels in these most highly affected countries would be in decline by the end of this decade. Apart from this, in most highly affected countries, slow growth in agricultural productivity and the overall economy resulted in growing food insecurity over the last two decades. The escalating scourge of HIV and AIDS in Lesotho and worldwide, warrants that stringent measures be put into effect to curb the spread and effects of HIV and AIDS. 1.2 HIV and AIDS Situation in Lesotho In order to put the HIV and AIDS in Lesotho into perspective, it is better to understand the country s macro-economy and the reasons for studying the pandemic s impact on agricultural production and food security. Table 1.1 below shows the macroeconomic situation of the country over the 5-year period from 2000 to Table 1.1: Lesotho: Recent Economic Performance Indicator GDP (US$bn) Real GDP growth (%)

14 Consumer Price Index Forex reserves (US$m) Exchange rate (M: US$1) Source: FAO/WFP Crop and Food Supply Mission to Lesotho, June 2005, Special Report Literature has shown that HIV and AIDS affect the most reproductive and productive age groups and increasingly impact adversely on the economy of the country. The first case of HIV and AIDS in Lesotho was reported in Since that time the disease has spread rapidly throughout the population. According to UNAIDS (2003), there were 40,000 adult Basotho aged living with HIV and AIDS in This had increased to 79,000 by 1997 and 92, 000 by 1998, representing a sero-prevalence of 9.8% of adults of this age group (Draft, Train of trainers Manual for Midlevel cadres, July 2001). Whereas UNAIDS indicated a prevalence rate of 31% in the year 2001 in Lesotho (UNAIDS, 2001), the country is ranked 4 th in its HIV prevalence after Botswana, South Africa and Swaziland. Table 1.2 below shows HIV and AIDS statistics in Lesotho from 1995 to Table 1.2: HIV and AIDS Statistics in Lesotho Year New HIV Estimated number of Adults Estimated New AIDS infections living with HIV/AIDS cases: Adults only ,316 53,346 2, ,793 66,926 3, ,559 79,982 4, ,623 91,664 5, , ,204 7, , ,174 9,052 Source: Lesotho Population Data Sheet According to recent statistics by UNICEF (2003), there were about 330,000 adults between the ages of 15 and 49 living with HIV and AIDS in Lesotho since 2001, and out of this number, 180,000 were women. The prevalence rate among pregnant women aged between 15 and 19 was 25% while that of those aged between 20 and 24 was 41%. According to May et al (2001), there is a possibility of underestimation of people living with HIV or who have full blown AIDS. This could be due to different data collection methodologies and under reporting. Jackson (2000) also noted that reported AIDS cases and AIDS deaths were notoriously unreliable, covering less than estimated one-quarter of actual cases in many countries. Table 1.3 below presents reported new AIDS cases by age and sex in Table 1.3: Reported new AIDS Cases in Lesotho by Age and Sex in

15 Age Group Females Males Total , Unknown Total 2,063 1,697 3,760 Source: Ministry of Finance and Development Planning, 2002 Lesotho Population Data Sheet. The statistics given above on the HIV and AIDS situation in Lesotho have serious impact on agriculture and food security in the country. Because HIV and AIDS affect primarily the productive age range of 15 49, it impacts more on productivity and production, at household, community, and national levels, and then ripple outwards to the firms, businesses and macro-economy. 1.2 Status of Agriculture and food security in Lesotho Lesotho is a small country about 30,000square metres. It is landlocked and heavily depends economically on South Africa. About 13% of the total area is suitable for cropping while the mountainous areas are good for livestock production. Agriculture contributes 17% to the GDP in Lesotho, while industries make up 43% and services make up 40% (FAO/WFP Crop and Food Supply Mission to Lesotho, June 2005). Due to reduced employment in the mines of South Africa and increased women migration to the textile factories in Lesotho, agricultural production has been adversely affected. With increased active labour migration, HIV and AIDS have also set in. The following section discusses livestock and crop production in the country Livestock Production in Lesotho The majority of rural households own livestock, in the form of cattle, sheep and goats. Many have a horse, two or more donkeys and chickens. Cattle are mainly kept for prestige. They however provide households with milk and meat to meet their dietary requirements. Sheep and goats are kept for wool and mohair respectively. Output of these products is also declining, mainly because of declining productivity per animal, and reduced animal numbers as a result of drought conditions. Horses are used as a means of transport while donkeys are used for draught power. 3

16 Table 1.4: Lesotho: Livestock Numbers in 2000/2001 District Cattle Sheep Goats Horses Donkeys Butha-Buthe Leribe Berea Maseru Mafeteng Mohale s Hoek Quthing Qacha snek Mokhotlong Thaba-Tseka Lesotho Source: Bureau of Statistics, Maseru The livestock sector is also facing another serious problem of stock theft. This theft is within and between villages, between districts and across borders. Since 1990, more than 70% of Basotho livestock owners reported their livestock stolen. Some of them had experienced stock theft more than once (Kynock et al., 2001). The situation is becoming increasingly dangerous as livestock theft is done violently by armed raiders. Moreover, it is having a negative impact on household food security. Livestock is a vital source of cash for purchasing of food when production is low. It also provides draught power for cultivation Crop production in Lesotho Maize, wheat and sorghum are the three major cereals produced in Lesotho. Other crops that are grown include beans and peas. Output in the crops sector has generally drastically declined Total production of the cereals has decreased in the last five years, from 191,000 tones in 1997/98 seasons to 53,800 tonnes in 2001/2002 seasons, which is a decline of 72%. A number of factors can be attributed to this yield decline. These include drought and reduced labour to work on the fields as more women (the major source of farm labour) resort to seeking employment in the textile industry, leaving men and children to do the bulk of agricultural work. According to Abbot (2003:115) low agricultural production can also be attributed to erratic heavy rainfall, early frost and delayed government input subsidies. Natural disasters may not be the sole contributing factor as reports maintained but care givers to HIV and AIDS patients also reduce labour that could otherwise be used for agricultural activities.. The table below shows cereal production by district over a five-year period in 2002/

17 Table 1.5: Total Cereal Production ( 000 tonnes) in 2004/05 compared to five-year Average District / / / /04 Five-year average 2004/ /05 as % of average Butha-Buthe Leribe Berea Maseru Mafeteng Mohale s hoek Quthing Qacha snek Mokhotlong Thaba-Tseka Lesotho Source: FAO/WFP Crop and Food Supply Mission to Lesotho, June 2005, p The Study Problem The impact of HIV and AIDS on the economies of the countries is tremendous. It is indicated that 14.4 million people are at risk of starvation in six heavily affected countries that include Lesotho, Malawi, Mozambique and Zimbabwe ( HIV and AIDS mostly affect the most productive age groups who are also breadwinners, thus resulting in a detrimental impact on household food security and nutrition. When a family member gets HIV and AIDS, a number of social problems occur, namely, a decrease in income, an increase in energy expenditure in care-giving and malnutrition of both the individual and family. Agriculture is one of the major sectors in Lesotho s economy. About 80% of the population live in the rural areas, where agriculture is the most important source of income and food security. Most families engage in subsistence farming which is not mechanized and mostly labour intensive. HIV and AIDS have affected agricultural produce and production in a number of ways which include the following: a. High rate of sickness and death in the families: This results in families exerting more of their energies in the care of the sick. For instance, they have to divert some of their financial resources to buy drugs. Sometimes families have to sell some of their assets in order to generate money for medical bills. For example, they have to sell some of their livestock like cattle, which are mostly used in farming.. In the case of death, animals are slaughtered for use in the burial ceremonies of the diseased persons, and this tremendously affects the livestock sizes. When a male family member who is an adult and a breadwinner dies, he usually leaves behind family members who are too young, unskilled and inexperienced to take good care of the livestock and farming. This eventually leads to a decline in agricultural produce. b. More valuable time spent on caring for the sick and preparing for funerals: The very young generation with great potential to be engaged in agriculture are also dying from HIV and AIDS. Some have to spend most of their energies in caring for the sick. Agricultural performance is also undermined because as more people die, family members, friends and colleagues take time off to prepare for and attend burials of loved ones. Sometimes young children who ought to be in school have to drop out of school in order to care for the sick or 5

18 because of financial constraints after losing parents to HIV and AIDS or due to diversion of funds for use in caring for the sick or their burial. c. Neglect and theft of livestock: Livestock is neglected, and this results in its theft. Therefore, families are deprived of their only source of protein, namely, milk and meat as well as draught power for farming. All these eventually aggravate reduction in food intake, thus leading to nutritional deficiency and gradual weakening of the immune system. As a result, individuals become more susceptible to an array of infections that weaken the body and eventual premature death. Amidst all these, improving nutritional status is likely to reduce HIV and AIDS outcome. The benefits of dietary and nutrition intervention are likely to be greatest at an early stage of the disease. A reduction in the quantity and quality of food, leads to malnutrition and decreases immunity to general infection. Infection with HIV damages the immune system, which leads to other infections such as fever, diarrhoea and oral thrush. These infections both increase demand for proteins and energy, and reduce food absorption and intake. In addition, drug management is more effective with good nutrition. The interrelationship that exists between nutrition and HIV and AIDS calls for concerted efforts of individuals, families, communities and government in the improvement of agriculture and food security in Lesotho. 1.4 Study Objectives The main objective of this study was to determine the impact of HIV and AIDS on agriculture and food security in Lesotho. Specifically, the study was conducted to determine the impact of HIV and AIDS on: Farm household production decisions; consumption expenditures, family size and composition, investment expenditure, and capital stocks. 1.5 Study hypotheses According to different experts, the HIV and AIDS scourge should be considered as a developmental issue and not just as a health one. It is interconnected to many aspects of development to the extent that it could be directly or indirectly involved in poor performance of such aspects. This study was premised on the following hypotheses: That HIV and AIDS infection adversely affects agricultural production by diverting household income from purchasing agricultural inputs and paying for agricultural activities into paying hospital bills and medication for household HIV-infected members; by killing the active labour force and increasing the dependency ratio at household level; by eroding domestic and agricultural assets and failing to make appropriate agricultural production decisions. That HIV and AIDS infection has both short and long-term impacts on food security at household level. For the country that is already facing arable land shortages and importing required foodstuffs, HIV and AIDS problem makes it difficult to source the foreign currency that is required for importation of food since many people are facing retrenchments while some are retiring due to HIV infection. 6

19 That households have to adjust their eating and dietary habits in order to accommodate the HIV-infected persons; and That HIV and AIDS infection negatively affects livelihoods within the affected households. 1.6 Study Rationale The HIV and AIDS studies have in the past focused more on the impact of the pandemic on health and society. Less attention has been on its impact on agriculture production and food security. In this study more attention has been on the pandemic s impact on the farming communities, agricultural production and food security. The agricultural sector is one of the most important sectors in the economy of Lesotho. It contributes 17% to the economy and it provides livelihoods to most Basotho. This explains the importance of studying the impact of HIV and AIDS on this sector, which is the source of livelihoods for the poor. The aim was to find out its impact on the labour force that produces food for the family; on the capital stocks that are required for sufficient production and securing of food for the household and overall expenditure. 1.7 Conceptual framework Conceptually the HIV and AIDS pandemic is a health, social, economic, political, agricultural and environmental issue. It has both long and short-term adverse impacts that require concerted multidisciplinary efforts to be taken at individual, household, community and national levels. According to the model below, the pandemic increases household vulnerability by having a negative impact on social, economic, political and physical stocks. Its negative impact on agricultural production has a direct impact on production and processing systems and food security. This impacts heavily on household livelihoods as it reduces accessibility to adequate and nutritious food on a sustainable basis. 7

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21 CHART 1: The Conceptual Framew ork for the Impact of HIV/AIDS on Agriculture and Food Security (FANRPAN, 2005) I M P A C T Social-economic impact Short Term impact Medium-term i mpact Long-term impact Impact on Individual Economic Impact Impact on household IMPACT OF HIV and AIDS Increased Mortality and changes in house-hold demographic structures Changes in Optimal Production Choices Increased Morbidity, vulnerability and poverty Changes in Expenditure mix Reduced Accessibility to food Decline in Household Consumption Changes in family labour size Decline in Agricultural extension services Reduction of house-hold livelihood assets Increased mobility of Household members Reduced marketing activities OVERALL IMPACT IS INCREASED HOUSEHOLD VULNERABILITY AND MORBIDITY Political Impact Impact on community PRODUCTION SYSTEM S PROCESSING SYSTEM S MARKETING SYSTEM S Impact on AGRICULTURE Impact on FOOD SECURITY Food Availability Production Purchase Storage Food Accessibility Income Purchasing Power Safety Nets Dependency Ratio Stability of supplies Food Utilisation Nutritional value Food safety Food Quality Adequacy IMPACT ON HOUSEHOLD LIVELIHOODS - Production & Income activities - Processing, exchange & Marketing activities - Consumption activities 9

22 1.7.1 Food Security Food security, as an issue, became prominent in the 1970s and has been a topic of considerable attention since then. Maxwell and Frankenberger (1992) identified thirty definitions of food security. Originally, there was a tendency to understand the issue of food security only from a supply point of view. In 1979, the World Food Programme Report conceptualised food security, equating it with an assurance of supplies and a balanced supply-demand situation of stable foods in the international market. The report also emphasized that increasing food production in the developing countries would be the basis on which to build their food security. This would mean that the monitoring by famine-early-warning systems for food insecurity should focus on the availability of food in the world market and on food production systems of developing countries. However, global food availability does not ensure food security to any particular country because what is available on the world market cannot be accessed by famine affected people in African countries as the economies of these countries in general, cannot generate the foreign currency needed to purchase food from the world market. Thus, there are countries, regions within countries, villages within regions, households within villages and individuals within households that are not able to meet their food needs. The paradox is that global food security exists alongside individual food insecurity (Odenya, 2003). Therefore, a global concept of food security does not guarantee food security at either the household or the national level. Odenya (2003), further argued that by the same token, an increase in national food production does not by itself guarantee food security. Availability of food at the national level is but one factor for food security. Supporters of this view try to work out a food balance sheet for a given country and if food availability is more or less equal to the food needs of the country s population in general, they conclude that the country is foodsecure. Given this perspective of food security, the basis for famine early warning would then be the monitoring of food production at the national level and may not take into consideration other important and relevant social, political and cultural factors. The assumption underlying the foregoing perspective is that whatever food is produced in the country will be evenly distributed to each region and to each household. But this is not the case in reality. Many people do not have enough money to buy food on the market and national governments often lack financial resources to provide food for the poor. Hence, food availability at the national level does not necessarily provide food entitlement to households and individuals. At the household level, Eide as quoted by M axwell and Frankenberger (1992), has defined food security as access to adequate food by households over time. This implies that each member of the household is secure, if the household in general has access to food. However, in reality food is not easily accessible to all members of the household. Maxwell and Frankenberger (1992) argued that it is misleading to assume that household members shared common preferences with regard to (a) the allocation of resources for income generation and food acquisition or (b) the distribution of income and food within the household. The head of the household may have more power in determining the use of food resources and may misappropriate it. M oreover, household members nutritional

23 requirements may vary as in cases where they exert more energy in work than others. Cultural factors can also deprive members of the household like women and children from getting an equitable share. Hence, the concept of household level food availability, in general, does not fit into the accepted definition of food security. Staatz (1990) defined food security as the ability to assure, on a long-term basis, that the food system provides the total population access to a timely, reliable and nutritionally adequate supply of food. According to the World Food Summit (1996) food security exists when all people, at all times have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. Food security has been interpreted broadly to include availability, access and utilization of food (see figure 1.1 below). Figure 1.1: Flow Chart showing food security and its components Food Security Food availability Phy sical Access to Food Food quality Social Access (Purchasing Power) to food Storage Trade Production Incomes Food Prices Safety Nutritional Food Health Nets Value safety Source: Rugube (2003) Drinkwater (2003:1) maintained that, Food security has conventionally focused on how households access food and in come they require for surviv al on an inter- and intraseasonal basis. If nutritional security is entertained additionally as a concept, then food security relates to the pathway of food into the household, and nutritional security to the nutritional outcomes, once the internal factors related to storage, preparation, distribution, health and mother care, have been taken into account. The Government of Lesotho has adopted a definition for food security to include food in sufficient quantities; access to everyone; nutritional adequacy and food safety (box 1.1). 11

24 Box 1.1: Defining Food security and Food Policy Government food policy refers to all activities of the government related to the production and availability of food in the country. Food security exists when every individual in the country has stable supplies of enough food to allow them to carry out daily activities efficiently. In order to be effective food security requires the following: Food in sufficient quantities, Access to that food by everyone Nutritional adequacy of the food Food safety food must be safe to eat. Food insecurity can be chronic, depending on long-term problems or trends, or transitory, usually resulting from emergencies, including famines, caused by drought, floods, wars, terrorism, other acts of violence or other disasters. Vulnerable people are those at risk of becoming food insecure in either sense. Government food security policy deals specifically with the part of food policy, which targets vulnerable groups and problems where access to food is threatened for all or some of the time. Source: Ministry of Agriculture and Food Security, 2003, Agricultural Sector Strategy: Statement of Policy and Strategy in Agricultural Sector. P167 According to the literature, there is increased population pressure on the arable land in Lesotho [Table 1.6], which suggests that many households no longer have adequate arable land to address their food security and nutritional security needs through farming.. Some of them have vegetable gardens only around their own homesteads. Table 1.6: Population density per square Km in Lesotho. Year Total Area Arable Land Source: 2002 Lesotho Population Data Sheet In this study therefore, food security is defined in terms of adequacy, availability, accessibility and utilisation of nutritious food to the HIV and AIDS affected household. Since in Lesotho there is a shortage of arable land, nutritious food include food produced by the households or food stuffs accessed using different legal methods and sources.. M any households that do not have cultivable land depend on sharecropping with those who have but cannot afford to farm. Some households depend on household income in order to purchase their foodstuffs.. Retrenchments from the mines in South 12

25 Africa and the closure of some of the textile factories in Lesotho have reduced household income that could be used to purchase food. Therefore, food security in Lesotho is based on purchased and produced food. It is important to find out whether households with HIV infected members could manage to be food secure even when they do not have arable land. 13

26 CHAPTER TWO Review of Literature Odenya (2003) argued that the impact of AIDS was shockingly broad and deep. It has been and will continue to be devastating for agriculture and food security in the region. The cohort most severely affected is the productive adult segment, and most of the affected population in the region is rural. Agricultural production and therefore food security is drastically impacted by the loss of workers, including the lost labour of households (especially women) whose energy is diverted to caring for those infected or orphaned by the disease. The circular effects result into poverty and food insecurity that enhance the spread of AIDS, both by impairing individuals immune systems, and by multiplying the vectors of infection. 2.1 HIV and AIDS and the Work Force The effect of HIV and AIDS such as repeated absenteeism due to either illness, care of the sick relative or loss of a relative impact severely on the business production. Economically, HIV and AIDS affect the workforce of the country in many ways, which include reduced labour supply and loss of skilled and experienced workers. Box 2.1 reflects these effects as expressed by Africa Development Forum 2000 in December Box 2.1: How HIV and AIDS affects the workforce Reduced supply of labour; Loss of skilled and experienced workers; Changes in composition of labour force and early entry of children into employment; increas ed pressure on women to earn income as well as care fo r the sick; Mismatch between human resources and labour requirements; Reduced productivity; Absenteeism and early retirement; Increased labour costs for employers; Loss of wage earners in a household; Reduced remittances from migrant workers; and increas e in fem ale-h eaded households. Source: Africa Development Forum, December 2000, HIV/AIDS in Africa: The impact on the World of work. Geneva: International Labour Office. Labour force projections indicate a big drop on the labour force for SADC countries [table 2.1]. For Lesotho the projections show a drop by 4.8% in 2005 and about 10.6% in This has implications for the labour force in agriculture and food security. 14

27 Table 2.1: Projected Labour Force Loss with HIV and AIDS in 2005 and 2020 within S ADC Country Percentage loss compared to situation without HIV and AIDS Botswana Democratic Republic of Congo Lesotho Malawi Mozambique Namibia South Africa Zambia Zimbabwe Source: ILO POPILO population and labour force projection, UN POP Division, World Population projects, the 1998, revision, Vol. III, abridged table from ADF 2000 p 5 in Analytical report. 2.2 HIV and AIDS impact on Agriculture and Food S ecurity Agriculture still remains the mainstay of many households in the SADC where over percent of the households are dependent on agriculture for livelihoods. In Sub-Saharan Africa that includes SADC, HIV and AIDS has, seriously affected farming and other occupations that provide livelihoods to the rural communities. ADF 2000 maintained that of the thirteen principal tasks in farming, ten are done mostly by women, who produce between 60 and 80 percent of food in Africa. The Forum saw the increasing incidence of infection among women as having serious implications for food security and the health of rural communities as well as the individual and her family. The impact of HIV and AIDS on agriculture was further confirmed by FAO. Their report entitled, The state of Food and Agriculture 2001, suggests that in Africa s 25 most affected countries, seven million farm workers had died from AIDS since 1985 and 16 million more might die within the next 20 years. Death of so many farm workers due to the HIV and AIDS epidemic was seen to have increased food insecurity. With increased percentage of retrenched mineworkers in Lesotho, the expectation was that the mineworkers were going to contribute to agricultural production. However, because of poverty that is now widespread (Sechaba Consultants, 2000), this has not been realized. Evidence has shown that the HIV and AIDS scourge spreads easily where poverty is rife as the opportunistic diseases take advantage of the situation. This has reduced the labour force in agriculture. The rate at which people are buried also impacts on agriculture, as culturally, agricultural activities have to stop to observe the sorrow during the funeral and to prevent hailstorms (according to Basotho cultural beliefs). This also has an impact on the environment since graveyards become full within a very short time and a possibility of recycling the graves in the near future is unlikely since decomposition takes time. People are now selling their fields for the graveyards in some of the villages. It would appear that families would end up opting for cremation to safe the environment, though culturally that will be a very hard decision to make. People still ignore their relatives wishes to be cremated when they are dead. 15