The impact of HIV/AIDS on rural households/communities and the need for multisectoral prevention and mitigation strategies to combat the epidemic in rural areas

Prepared by
Erich G. Baier

TSS Senior Population Officer
Population Programme Service
Women and Population Division

Food and Agriculture Organization of the United Nations (FAO)
Rome, January 1997

Preface

With the Program me of Action adopted by the Cairo International Conference on Population and Development (ICPD), population issues have been placed at the centre of the development agenda by emphasizing the close relationship between population and sustainable development as well as the need to improve the population/food supply balance through a holistic approach to agriculture and rural development, which will include gender, environmental, population/HIV/AIDS and sustainable rural development issues. The Program me of Action places the well-being of women and men at the contra of sustainable development, rather than focusing on demographic concerns and targets.

The shift from family planning to reproductive health has resulted in added interest in sexually transmitted diseases (STDs) and HIV/AIDS from a population Program me perspective. Major efforts are under way to integrate STD/HIV/AIDS prevention and mitigation activities into reproductive health programmes. It is against this background that a number of concerns for rural populations and the role of agricultural extension services are presented and discussed.

The purpose of the present paper is to help population specialists at the regional and country levels carry out the following specific tasks:

· promote awareness of population/HIV/AIDS and rural development linkages and related issues through appropriate rural development policies and agricultural extension programmes;

· assist to integrate population/HIV/AIDS concerns and considerations into agricultural development and extension policy analyses;

· assist in the design and implementation of data collection and rapid rural appraisal (RRA) studies on population/HIV/AIDS issues;

· initiate the design and implementation of population/HIV/AIDS-related research in support of agricultural production systems and sustainable rural development studies in HIV/AIDS-affected areas.

For this purpose the paper reviews relevant articles and/or publications and provides factual information on HIV/AIDS issues as they affect agricultural extension services and proposes agricultural extension strategies to prevent the disease and to mitigate its impact on rural people in cooperation and coordination with relevant technical services.

It must be noted that the knowledge on the impact of HIV/AIDS on agriculture/ rural development is drawn from studies carried out in eastern Africa, therefore, impacts could be different in other regions. Still, it is believed that the type of issues raised could be useful for other regions as well.

This paper will be addressed to UNFPA Country Support Team Directors, Regional IEC Advisers, UNFPA Country Representatives and FAO regional, subregional and country offices. Suggestions for further distribution will be welcome.

Erich G. Baier

1. Introduction

Recent data suggest that the HIV/AIDS epidemic is continuing to evolve. It is estimated that over 90 percent of the close to 30 million people who are thought to have been infected worldwide with the virus since the start of the epidemic live in developing countries. With around 14 million HIV-infected adults and children as of late 1996, sub-Saharan Africa is the region hardest hit. This represents around 65 percent of the world total. Of the 8 500 new infections that occur daily worldwide, 50 percent are in sub-Saharan Africa. It is estimated that around 5 million adults and 1.4 million children worldwide have already died since the start of the global epidemic. (For the end 1996 global estimates, see Annex I.)

In each country the details of the epidemic vary, having its own distinct origin, geographic patterns of dispersion and particular population subgroups affected. At present, reliable comprehensive statistics for HIV/AIDS infections do not exist; however, those that do exist are alarming. If the current epidemic trends continue through the end of this decade, it is estimated that between 30 and 40 million adults will have been infected with HIV by the year 2000. Of these, about 60 percent will be in sub-Saharan Africa.

Over 50 percent of new HIV infections occur in women. This is alarming since women carry the main burden of care of family members with HIV/AIDS. In countries where young people account for 60 percent of all new infections, infected young women outnumber their infected male peers by a ratio of 2 to 1. UNAIDS estimates that close to 8 million women in sub-Saharan Africa (out of 10 million women infected worldwide) are HIV-positive.

HIV/AIDS is no longer restricted to cities. The disease is now spreading with alarming speed into rural areas and affects the farming population, especially people in their most productive years (ages 15 to 45). However, there is also some evidence of stabilization in HIV infection rates in certain areas of East and Central Africa. In one rural district of southwest Uganda, the percentage of those aged 13 and above acquiring HIV infection each year declined from 7.5 percent in 1989-1990 to 4.5 percent in 1993. This is attributed to success in changing sexual behaviour.

Although interrelations between the epidemic and overall development have been acknowledged, the linkages to agriculture have received less attention because the epidemic was perceived as being largely urban. The existing evidence of the spread of the epidemic to rural areas was often overlooked because of poor data, the irregular patterns of spread and lower prevalence than in urban areas. A lesson that should be drawn from this epidemic of global dimension is that technical assistance agencies, including FAO, should combine their efforts to improve the existing mitigation and prevention strategies to manage the impact of the epidemic on agricultural production and food security and combat the disease in rural areas.

While prime concern was aimed at eastern Africa in assessing the socio-economic impact of HIV/AIDS on rural households and their production systems, little is known about the impact of the epidemic on agriculture and rural societies in West Africa. FAO is currently carrying out a UNDP-funded TSS-1 project "The Effect of HIV/AIDS on Agricultural Production Systems and Rural Livelihoods in Western Africa (Côte d'Ivoire, Burkina Faso)" which focuses on the pastoral population, rural migrants, nutritional implications, etc.

A previous paper, "The Impact of the HIV/AIDS Epidemic on Agricultural Production and Productivity and the Role of Extension Services in Combating the Disease in Rural Areas (Especially in Africa)", explores the impact of the HIV/AIDS epidemic on agricultural production systems and highlights the consequences for agricultural extension programmes in rural areas affected by the disease. The present paper follows up on the issues presented in the previous paper and focuses on the impact of the epidemic on rural households/communities and the need for immediate, medium-term and long-term strategies to control and combat the disease and to mitigate its consequences in rural areas.

For this purpose, selected study findings on the impact of HIV/AIDS on agricultural production systems and rural household food security will be reiterated and fundamental problems and major challenges for agricultural extension, including HIV/AIDS-related farmer education and training programmes, will be highlighted. In addition, possible directions and actions to strengthen agricultural extension programmes are proposed, especially with regard to farmer education and training activities.

The immediate and medium-term response of agricultural extension programmes to the effects of the HIV/AIDS epidemic could focus on a reorientation of extension programmes with an emphasis on problem-solving activities for affected households and communities (focusing on training and extension activities for women, orphans and youth) and on the initiation of collective efforts to strengthen community and group organization in support of traditional coping mechanisms to mitigate the effect of the disease. In addition, systematic, location-specific surveys could collect relevant information on the actual impact of the disease on rural households and extension programmes.

A long-term strategy to strengthen extension programmes in countries affected by HIV/AIDS could include a systematic approach to improve research inputs for the development of less labour-intensive crops and production methods. Furthermore, priority should be given to the integration of gender issues into extension programmes and an effort made to improve women's participation in extension activities. In addition, assistance (including appropriate legal support for HIV/AIDS widows) could be provided to vulnerable groups/communities through multidisciplinary HIV/AIDS programmes. Ministries of agriculture and their outreach programmes will have to play a key role in addressing the special needs of rural households/communities in such multidisciplinary HIV/AIDS programmes, which could be launched as integral part of a poverty alleviation Program me in HIV/AIDS-affected areas.

2. The impact of HIV/AIDS on agricultural production: effects at the household level

The detrimental impact that HIV/AIDS may have on rural households' productive capacity has been explored in studies in eastern Africa. The earlier paper (quoted above) suggests that the effects of HIV/AIDS are felt on two key farm production parameters. First, household labour quality and quantity are reduced, initially in terms of productivity when the HIV-infected person is ill, and later the supply of household labour falls with the death of that person. Moreover, the probability that more than one adult per family is infected is high, given the heterosexual nature of HIV transmission in Africa. A compounding factor is that infection rates are higher among women, who account for 70 percent of the agricultural labour force and 80 percent of food production. In addition, other household members will devote productive time to caring for the sick persons and traditional mourning customs, which can last as long as 40 days for some family members, can adversely affect labour availability.

The second factor of household agricultural production that HIV/AIDS will affect is the availability of disposable cash income. During episodes of illness, household financial resources may be diverted to pay for medical treatment and eventually to meet funeral costs. Such resources may otherwise be used to purchase agricultural inputs, such as occasional extra labour or other complementary inputs (e.g. new seeds or plants, fertilizer, pesticides, etc.). Family assets (e.g. livestock) might be sold off.

If a household becomes unable to either supply such labour internally or hire temporary workers, the composition of crops may be gradually altered, shifting from cash to subsistence crops in some cases. The key constraint will be during periods of peak labour demand, usually in planting and harvesting seasons. Given the nature of the rural labour market, these are also times when wages or opportunity costs are highest. Another response to labour shortages may be to reduce the area under cultivation. Furthermore, it is likely that livestock production may also be less intensive and that the farming quality will be affected with weeding and pruning activities curtailed. The shift from high labour-intensive crops to low labour-intensive crops will stop vegetable cultivation resulting in a less varied and less nutritious diet.

Labour-intensive farming systems with a low level of mechanization and agricultural input are particularly vulnerable to the impact of the disease. Some of the effects of labour shortage in full impact communities in Eastern Africa are:

· reduction in the acreage of land under cultivation;

· delay in farming operations such as tillage, planting and weeding;

· reduction in the ability to control crop pests;

· decline in crop yields;

· loss of soil fertility;

· shift from labour-intensive crops (e.g. banana) to less labour-intensive crops (such as cassava and sweet potatoes);

· shift from cash-oriented production to subsistence production;

· reduction in the range of crops per household;

· decline in livestock production;

· loss of agricultural knowledge and management skills.

The results and findings of FAO's activities carried out in eastern Africa reveal that the impact of HIV/AIDS on agricultural production systems and rural livelihood cannot be generalized, even within one country, and must be disaggregated into spatial and temporal dimensions. Studies conducted in Uganda, the United Republic of Tanzania and Zambia have shown that HIV/AIDS follows a different pattern in each village and district. Geographic and ethnic factors, religion, gender, age, marriage customs and agro-ecological conditions play a role in the pattern and impact of HIV/AIDS and in people's perception of the disease. Communities can be grouped in pre-impact (infections exist, but the impact of the disease is not visible), early impact (visible impact, but community coping mechanisms still work) and full-impact communities (high prevalence of HIV/AIDS-related morbidity and mortality, traditional coping strategies do not work any more). This differentiation is important for the planning and implementation of location-specific intervention strategies.

3. The impact of HIV/AIDS on traditional coping mechanisms in rural economies

The economic and social consequences of the disease directly affect the rural family. In the absence of functioning medical care systems in African countries, medical costs and caring for sick family members must be borne entirely by the nuclear family or by the extended family network. In addition to the medical costs, which include the cost of drugs and traditional medical treatment, funeral expenses of family members are a heavy burden on the family budget. Funeral costs appear to be even higher than medical expenses in some settings.

Farmers have developed mechanisms to cope with the impacts of HIV/AIDS on their rural livelihood strategies. Traditionally, in emergency situations caused by natural disasters and in hardship situations, the extended family network has developed successful coping mechanisms, which are still operational in pre-impact and early impact communities. However, the rise of HIV/AIDS related morbidity and mortality in full-impact communities, where the impact of the disease already leads to the breakdown of the nuclear families, the traditional coping mechanisms are strained to the breaking point.

Traditional coping mechanisms are based mainly on returns to labour at the farm and/or family unit. Even the contribution of child labour may be increased (with children, particularly girls, withdrawn from school) as the family struggles to maintain the current cropping patterns. But, as a family becomes more impoverished, it may have little choice but to produce for its own consumption needs. Even then, family nutrition levels could be gradually compromised. It is not uncommon in full-impact districts/communities to observe entire families of children with elderly grandparents as their only form of support.

Since HIV/AIDS is above all a sexually transmitted disease, very often more than one family member is affected and dies. As a result, the entire assets and savings of many families, which are generally meagre before the onset of the disease, may be completely spent, leaving the surviving family members without means of support. A study in Uganda has shown that the burden of the socio-economic impact of HIV/AIDS is disproportionately affecting rural women. In the districts studied, more households were found to be headed by AIDS widows than by AIDS widowers. Widows with dependent children became entrenched in poverty as a result of the socio-economic pressures related to HIV/AIDS. Widows lost access to land, labour, inputs, credit and support services. HIV/AIDS stigmatization compounded their situation further, as assistance from the extended family and the community, their main safety net, was severed. The extent to which malnutrition rates in affected households rises depends on the type of coping mechanisms, household resource constraints, socio-cultural context and emotional stress. As the ability to produce and accumulate food and income decreases, the household falls into a downward spiral of increasing dependency ratios, poorer nutrition and health, increasing expenditure of resources (time and money) on health problems, more food shortages, decreasing household viability, and increasing reliance on support from extended family and the wider community. The effects of HIV/AIDS on rural households, and the likely impact of the disease on farmers' health and the nutrition of farm families, is depicted in Table 1. The complexity of the impact of the disease on agricultural production and household food security requires a multisectoral response that should include agricultural extension, primary health care, education and appropriate non-governmental organizations (NGOs).

Furthermore, it has been observed that the decline in farm income caused by a decline in cropping intensity and livestock production, which is accompanied by an increase in medical expenses and funeral costs, can lead to the breakdown of the nuclear family and the traditional support system. The interlinkages between the increase of HIV/AIDS-related mortality and morbidity, the lack of farm inputs and labour force, the deterioration of household economy and the impact on education, health and the social system, which eventually lead to a breakdown of the traditional coping mechanisms, are presented in Table 2 on page 9.

The Joint United Nations Program me on AIDS (UNAIDS), which is the UN System's main advocate for the global response to the epidemic, is dedicated to preventing the transmission of HIV, reducing the suffering caused by HIV/AIDS, and countering the epidemic's impact on individuals, households, communities and societies. UNAIDS brings together at country level the many and varied technical and operational strengths of its cosponsoring agencies to enhance the quality of assistance to national responses to AIDS. UNAIDS can thus assist in strengthening traditional coping mechanisms by, first of all, ensuring effective and coordinated support by the UN System to the national HIV/AIDS Program me UNAIDS provides technical support, training and monitoring to ensure that all national actors have access to information on international best practices and, in turn, to ensure that their country experiences help shape the global policies and programmes. It is to be noted that UNAIDS does not fund projects except under specific circumstances. UNFPA CSTs, UNFPA Country Representatives, FAO regional, subregional and country offices should collaborate with UNAIDS at regional and country levels to promote a multisectoral response to the epidemic.

4. The impact of HIV/AIDS on the extension service

Agricultural extension is one of the central institutions dealing with human resource development and technology transfer to farmers and rural households in most countries in the world. As agricultural development in a country moves forward, the knowledge and technology needs of farmers and farm households continue to increase. In countries where farm households have low levels of literacy and more traditional farming systems, extension programmes will generally be more educationally focused, aiming primarily at human resource development in rural areas. These extension systems, often functioning as integrated agricultural and rural development programmes, help farmers form organizations/associations, such as commodity groups and cooperatives, and promote the use of government services and improved technology.

Some extension systems may expand their human resource development focus to include rural youth, child development, nutrition and household management programmes. Broad-based extension systems that include agriculture, population education, environment, home economics, rural youth, gender and community development components are essentially designed to improve the welfare of rural households and communities rather than achieve more limited agricultural production and technology transfer objectives.

Participants at FAO's 1989 Global Consultation on Agricultural Extension recognized that economic pressure is forcing extension in many countries to justify itself on more immediate economic criteria that are closely related to technology transfer and increasing agricultural productivity, thus ignoring extension's traditional role in human resource development. They pointed out that pursuing an extension system that is narrowly focused on technology transfer risks promoting growth without equity. Unless the educational and technology needs of all major groups of farmers are effectively addressed, the long-term consequences will likely lead to a small proportion of very productive commercial farmers and the vast majority of rural people being left behind at the subsistence level in conditions of pervasive rural poverty thus jeopardizing the success of population programmes. The socio-economic impact of HIV/AIDS on rural households requires a broad-based agricultural and rural development concept that is based on a more balanced approach to extension that takes the specific HIV/AIDS-related needs of different rural groups into consideration.

An FAO-sponsored survey of 207 agricultural extension organizations in 113 countries revealed that an estimated US$ 6 billion was spent in 1988 on extension activities worldwide. The survey results indicated that there are approximately 600 000 extension workers for 1.2 billion farmers worldwide. Based on the survey results, it is estimated that in 1988 approximately 58 percent of extension resources (including time) worldwide were directed towards commercial farmers, including specialized producers of cash crops and export commodities. Only 22 percent of extension resources were directed towards subsistence farmers and 7 percent towards rural youth and young farmers. The proportion of female extension workers in 1988 worldwide was estimated to be about 16 percent, and yet only about 5 percent of extension resources had been directed towards women farmers. It is unlikely that these trends have changed substantially in recent years. It should, however, be noted that structural adjustment programmes have resulted in drastic reductions in extension budgets and staff and created an institutional vacuum in some countries.

As recommended in the Rome Declaration on World Food Security, in addition to the need of increasing food production, the need for policies conducive to investment in human resource development, research and infrastructure for achieving food security is recognized, with a focus on the alleviation of poverty among the rural poor. The World Food Summit Plan of Action stressed the importance of giving special attention to providing agricultural development services, including education, extension and training, to disadvantaged groups -- small farmers, rural women and youth. In view of the detrimental impact of HIV/AIDS on rural economies, agricultural planning authorities need to place this concept at the contra of their concerns and efforts.

Agricultural extension is in transition worldwide. Governments and international agencies are advancing structural, financial and managerial strategies to improve extension programmes. Decentralization, cost-sharing, cost-recovery, participation of stakeholders in development initiatives and the decisions and resources that affect them -- these are some of the elements in extension's current transition.

Given the problems and challenges mentioned earlier, priority should be given to improving and strengthening extension services, especially through farmer education and training, to meet the challenges of ensuring sustainable agricultural and rural development in HIV/AIDS-affected rural areas. Fundamental policy changes and new strategic directions or approaches are urgently required to increase the efficiency of providing relevant agricultural extension and training programmes to farm families, focusing on small-scale and resource-poor farm households, and especially targeting rural women and youth. The following suggestions for improving extension activities only provide general directions for action. Each farmer education/training activity has specific goals, problems or needs. An appropriate extension strategy will have to be developed based on the results and findings of location-specific assessment surveys, cultural context analysis and the needs of the respective target beneficiaries.

4.1. Immediate and medium-term extension activities/strategies to alleviate the consequences of the HIV/AIDS epidemic

The impact of HIV/AIDS on agricultural production systems and the decline of agricultural knowledge and management skills, as well as the disproportionate impact of the disease on rural women, which cumulatively lead to the loss of rural household food security, the deterioration of traditional coping mechanisms and dwindling of family and community resources, does have a direct impact on the performance of extension services. However, there is little precise information on how the impact of HIV/AIDS is affecting the performance of agricultural extension services in specific locations.

Hence, there is an urgent need for appropriate location-specific assessment surveys, which could provide precise quantitative and qualitative information on the scope of the impact of the disease on agricultural production, rural households and the work and coverage of extension services. Such surveys should also collect information on how HIV/AIDS related morbidity and mortality affects the availability of trained staff and the coverage of extension services. In addition, precise information is needed on the legal aspects involved in HIV/AIDS-related mortality and the implications on land rights and inheritance laws for widows and orphans. Furthermore, data on the specific implications of HIV/AIDS on small-scale and/or landless farmers and women, as well as on the availability of household labour, savings, cash and other socio-economic data need to be collected. The assessment of the current status, likely future development and prospective demographic, social and economic impact of HIV/AIDS in a specific rural district/community needs to be undertaken in a joint effort with all agencies and selected NGOs represented in the respective district/community. A limited rapid rural assessment survey could meet the immediate needs focusing on the impact of HIV/AIDS on households, communities, health facilities, traditional healers, traditional coping mechanisms and survivor assistance programmes.

The results and findings of such location-specific surveys need to be analysed and used as inputs for the design of problem-solving, action-oriented interventions and for the planning of appropriate extension strategies, including development of adequate training programmes and training support materials; empowerment of women by providing relevant training and extension advice; strengthening of traditional coping mechanisms; and the promotion of cost-effective survivor assistance programmes for orphans, widows/widowers and elderly farmers. FAO's Agricultural Extension and Education Service (SDRE) envisages possible studies and training activities related to the HIV/AIDS pandemic with a focus on its implications/consequences on agricultural extension programmes. For more details on these activities, see Annex 2 (4).

In view of the devastating impact of HIV/AIDS on rural economies and farm families, extension interventions cannot focus any longer only on the technical aspects of agricultural production and livestock development. Frequently, the extension service is the only government agency represented in rural areas and the extension workers are the only rural resource persons who can assist rural families in alleviating the socio-economic consequences of the disease. However, agricultural extension staff need to be guided and trained to utilize their community organization skills to assist the most vulnerable groups in affected communities to pool their expertise and knowledge and reinforce their confidence. They should also assist affected rural communities in undertaking on-farm as well as off-farm income-generating activities and facilitate self-help associations to provide immediate assistance and support to HIV/AIDS widows/widowers and orphans.

One of the immediate and medium-term means of increasing the effectiveness and efficiency of agricultural extension programmes to meet the challenges and to alleviate the consequences of HIV/AIDS is through the application of improved and innovative extension methods. FAO/SDRE's field experiences in the last decade have demonstrated the importance of extension methodologies that rely on strategic planning applications and participatory approaches that can minimize inputs or resources and maximise outputs or results. A Strategic Extension Campaign (SEC) methodology developed by FAO/SDRE has been introduced in Africa, the Near East, Asia and Latin America. This methodology emphasizes the importance of people's participation (i.e.. intended beneficiaries such as field extension workers and small farmers) in strategic planning, systematic management and field implementation of agricultural extension and training programmes. Its extension strategies and messages are specifically developed and tailored based on the results of a participatory problem identification process on the causes or reasons of farmers' non-adoption, or inappropriate practices, of a given recommended agricultural technology or innovation.

The SEC technology transfer and application approach is needs-based, demand-driven, and has a problem-solving orientation. The SEC methodology has been developed to focus on specific issues related to a given agricultural technology recommendation. Basic concepts and principles of SEC have been used in the efforts to integrate population education and environment issues/concerns into agricultural extension activities in selected FAO member countries. Most of the important principles and techniques employed in planning, implementing and managing SEC activities would be applicable to developing and implementing problem-solving extension activities to mitigate the consequences of the HIV/AIDS epidemic an) to support the Ministry of Agriculture's policies, strategies and priority programmes. The SEC methodology is useful to agricultural extension services and to small farmers because it:

· advocates a participatory planning approach;

· is needs-based and demand-driven;

· uses strategic planning and integrated systems approach;

· considers the human and behavioural dimensions;

· has a problem-solving orientation;

· employs a cost-effective multimedia approach;

· provides specific extension support materials and training;

· has built-in process documentation and evaluation procedures;

· is applicable to other extension programmes.

There is a need to promote more egalitarian gender relationships in families and communities. All reproductive health (RH) programmes should specifically include a HIV/AIDS prevention strategy. Because RH programmes have traditionally targeted mainly women, the strategy should be designed to increasingly address men. Men's relative authority in all ranges of life, from personal relationships to making national policy, needs to be openly discussed. Strategies for encouraging and enabling men to channel their power constructively at these various levels should be developed and factors inhibiting this should be identified. Lessons learned from the perspective of male motivation for population and family planning programmes should be taken into consideration for reproductive health promotion and multisectoral programmes of HIV/AIDS prevention and mitigation.

Agricultural extension can assist farm households and specific target beneficiaries most affected by HIV/AIDS to become organized into functional groups and/or community organizations, such as commodity groups, cooperatives, farmers clubs, etc., that will directly serve their immediate needs. Such group segmentation of target beneficiaries can increase the effectiveness and efficiency in the delivery of agricultural extension and reproductive health advice, including appropriate training by developing demand-driven, needs-based and problem-solving extension and reproductive health activities.

4.2. Long-term strategy to strengthen extension programmes

In full-impact communities, where HIV/AIDS-related morbidity and mortality are already high, extension programmes may have to be revised based on the actual impact of the disease on agricultural production systems, rural households and food security. Specific target groups such as widows/widowers, orphans and elderly farmers will have to be given special attention. As part of the long-term strategy for rural development in the presence of HIV/AIDS research linkages and research inputs could be directed towards the development of less labour-intensive crops and production methods bearing in mind the minimum nutritional value required. Research has to correspond more closely to the needs of farm households with fewer working adults.

Farm support services could be strengthened to ensure that technical advice, credit and forms of labour substitution are available. The development of appropriate technologies to reduce the time spent on water and fuel collection, for example, could be critical in releasing more labour for agricultural tasks. Research into the maintenance and creation of income-generating opportunities in rural areas as alternatives to agriculture, particularly for those for whom the physical effort of farming is no longer feasible, is also essential. A good socio-cultural assessment of these communities will allow to devise mechanisms to alleviate the impact of the spread of the disease on the social fabric of rural communities. Traditional household and village structures that normally play a critical role in family welfare and resource management are under strain. Research could be done into agricultural and social coping mechanisms and the experiences be shared between areas with similar farming practices.

Furthermore, the specific needs of rural youth need to be addressed in a systematic way. Among both men and women, the hardest-hit group are young people. UNAIDS estimates that half of all infections to date have been in 15- to 24-year-olds. In some countries, 60 percent of all new HIV infections are in this age group, with a female to male ratio of 2 to 1 among 15- to 19-year-olds.

Unless special attention is paid to young people, particularly girls, in rural areas by extension services, they tend to be ignored. Especially in communities affected by HIV/AIDS, it is not enough for extension services to claim that they target rural youth. One of the lessons learned from field experiences of FAO/SDRE's youth activities is that extension services must have an identifiable, formally structured youth Program me in order to reach rural young people in an effective manner and that it should have a gender-specific approach.

One of the major recommendations coming out of FAO's Expert Consultation on Extension Rural Youth Programmes and Sustainable Development, which was held in Rome from 29 November to 1 December 1995, is that any comprehensive extension service targeting, rural families must have a strong rural youth programme component. The special reference to HIV/AIDS is that, especially in high-impact areas, rural youth extension programmes could help to effectively fill the void caused by the loss of agricultural knowledge at the community level as many family members in the "productive" age groups are dying. Young people need to be trained in sustainable agricultural technology appropriate to the changing situations caused by the epidemic in their communities. Older citizens, largely unaffected themselves by the disease, can be mobilized as local volunteer leaders through the rural youth extension Program me with adequate training and support, to share their valuable knowledge and skills on agricultural practices.

There is a growing body of knowledge showing the relationship between effective reproductive health education programmes. and the incidence of HIV/AIDS. Experience indicates that educational attention to sexuality and reproductive health issues tends to lead to a reduction in sexually transmitted diseases, including HIV/AIDS. While agricultural extension services are having difficulties working with adult women and men in addressing reproductive health issues, rural youth extension programmes can easily incorporate this sensitive subject matter into ongoing educational programming with groups of girls and boys and/or young women and men.

In terms of the role of extension in HIV/AIDS prevention youth programmes may have the potential for greatest impact from two perspectives: first, in high-impact communities where morbidity and mortality are high, prevention may be already too late for the adult population; and, second, adults tend to be set in their way of life and it may be difficult to change their sexual behaviour. Research shows that it is often easier to change the beliefs and practices of young people. Effective HIV/AIDS prevention education programming for extension services, therefore, needs to target specifically rural youth.

One of FAO's studies on the socio-economic impact of HIV/AIDS in Uganda found a very direct relationship between the use of alcohol and drugs and sexually risky behaviour. Although it is not common for agricultural extension services to target adults and youth to create awareness about the detrimental consequences of drug and alcohol abuse, it should be taken into consideration that it is relatively easy for extension workers with proper support and training to incorporate a drug demand reduction component into ongoing extension rural youth programming.

It is generally acknowledged that risky and destructive behaviour directly leads to low personal self-esteem, especially among young people. Rural youth extension programmes can contribute significantly to boost moral, and self-esteem of youngsters. Such programmes motivate young people to get involved in productive activities, often resulting in some financial gains. They enable girls and boys, through training and practice, to develop leadership and interpersonal communication skills that can help them work effectively with peers in accomplishing concrete tasks. Many rural youth extension programmes have member and voluntary leader recognition programmes to acknowledge their accomplishments and provide public recognition. All of these factors contribute to enhance the self-esteem of young people.

Another long-term response of agricultural extension services to the impact/consequences of HIV/AIDS could be a systematic Program me of action to integrate gender issues in their programmes/activities. In view of the fact that only few women receive extension advice on field crop production and other farm-related activities, despite their involvement in agricultural production and farm management, the issue of increasing women's participation in extension activities needs to be urgently addressed. In order to enable extension services to address the priority needs of rural women the following actions should be taken into consideration:

· collect, analyse and report sex-disaggregated data;

· gain a solid understanding of the power relationships between the genders;

· facilitate conditions for women to be able to attend extension Program me activities/meetings;

· set targets for women's participation in extension based on the actual involvement of women in crop and livestock production;

· base extension activities and messages on diagnosed gender differences in activities and resources;

· develop a technical manual and appropriate training support materials for a wide range of women's activities;

· appoint extension agents, or gender coordinators, to facilitate women's access to agricultural support services available from the Ministry of Agriculture and other government ministries, NGOs, projects, etc.;

· train representatives of rural women's groups in financial, production and human resource management for group activities;

· promote on-farm and off-farm income generating activities by facilitating women's access to credit, tools and other inputs.

Rural youth extension programmes. which generally work with mixed groups, could offer a safe environment where girls and boys, by meeting and working together, learn and practice appropriate gender roles. Purposefully structured learning activities can enhance the development of gender roles, which are known to have direct implications on HIV/AIDS infection.

In many developing countries it has been noted that few women apply for extension posts because they lack the technical training. In addition, cultural norms prevent them from accepting posts/assignments away from their parents or husband/family. In order to meet the declared demand for female staff in agricultural education and extension programmes. the following measures/activities are recommended:

· Because in the immediate future most extension agents will be male, they must be trained to work with women clients where possible. They also need appropriate technical training in women's activities and how to initiate extension contacts with women farmers in a culturally acceptable way. Furthermore, they need to be trained in the organization of women's groups.

· The number and status of female staff should be increased by, for example:

- selecting experienced female staff for in-service training and upgrading;

- providing training in agriculture to rural women and also integrating trained rural women in other ministries; and finally

- encouraging the enrolment of female students in agricultural training colleges (through scholarships).

A broad-based extension and education approach requires policy, technical and organizational support from all relevant government ministries/departments and NGOs. Hence, there is a need to encourage and promote an improved, closer and institutionalized collaboration and coordination with agriculture-oriented government agencies/institutions and NGOs, as well as with nonagricultural ministries/agencies and their decision-makers/officials, e.g. those dealing with health, population, environment, education, youth, etc. From a technical point of view, better functional linkages will need to be developed with appropriate multidisciplinary groups of scientists/researchers, technicians, relevant specialists, etc., who are qualified to contribute to the development and implementation of HIV/AIDS prevention and mitigation programmes.

4.3. Multisectoral HIV/AIDS control programmes with a focus on sustainable agricultural and rural development

With the increasing impact of HIV/AIDS on agricultural production systems threatening rural, urban and national food security, the agriculture sector needs to be at the forefront of concern. Cultural propensities, nucleated village organization patterns, the dynamics of estates/plantations labour force and particularly the location of villages along highways cumulatively make the rural areas, and thus the agricultural economy, highly susceptible to infection and the effects of HIV/AIDS. In order to meet the major challenges for rural economies, including farmers and extension programmes, closer collaboration and coordination between ministries of agriculture and nonagricultural ministries, institutions and/or agencies should be urgently initiated or improved. Existing national HIV/AIDS programmes also require agriculture sector-based interventions to mitigate the devastating effects of the disease in rural areas.

The main focus of a multisectoral HIV/AIDS Program me should therefore go beyond prevention of the disease and give increasing importance to the aspect of mitigation of the HIV/AIDS impact. The Program me strategy requires a coordinated and concerted effort based on a consultative and interactive process through decentralized Program me implementation and full community participation. Agricultural education and extension programmes will have to play a key role in the implementation of such programmes.

4.3.1. Operational framework

(a) Policy adjustments

Rural development policy in sub-Saharan Africa must begin to consider the growing labour constraints associated with HIV/AIDS and the potential widespread disruption to the rural economy and social structure. Government policy in the past has been geared towards labour-intensive food production strategies on the basis of continued high population growth rates. In certain areas of Africa these assumptions may have to be reexamined. Policy recommendation about the relative merits of particular crops in any farming system must now take into account the impact of HIV/AIDS on labour and income, spelling out realistic goals, objectives and implementation strategies.

(b) HIV/AIDS-related database

Most of the information on the impact of HIV/AIDS on rural economies is based on anecdotal observations. Ministries of agriculture, therefore, should prepare an inventory of the existing information and of relevant ongoing projects/activities with regard to HIV/AIDS related to agriculture, and then systematically collect further data and information to identify in a scientific way the actual HIV/AIDS situation in specific localities and determine the linkages between the epidemic and agriculture. More specifically, the following major aspects should be taken into account:

· impact on local food production and income of rural households;

· farming systems that are highly vulnerable to HIV/AIDS;

· migration and migrant labour;

· impact of the disease on pastoralists;

· impact on cash crop production (rubber, bananas, coffee, tea, sisal, sugar, etc.);

· impact on farm households and rural communities;

· impact on the national economy, especially exports and foreign trade.

The results and findings of the data collection exercise need to be used as inputs for national planning and Program me formulation purposes, as well as for regional and local mitigation strategies targeting individual farmers, families and communities.

(c) Strategic framework and action plan

The Ministry of Agriculture, in coordination with the Ministry of Health and other relevant ministries and NGOs, should prepare and formulate a strategic framework for the national AIDS control Program me and develop viable projects/activities to mitigate the impact of HIV/AIDS on agriculture and household food security based on location-specific information/data. In view of the rapid spread of the HIV/AIDS epidemic into the rural areas, the following immediate, medium-term and long-term goals should be taken into consideration:

(i) Immediate:

- Develop a monitoring unit in the Ministry of Agriculture with the capacity to plan, coordinate and monitor the HIV/AIDS-related activities in-house and coordinate with other relevant agencies.

- Sensitize the staff of Ministry of Agriculture and other relevant agencies, both at the policy and management levels and in the field, about the socio-economic impact of HIV/AIDS on agricultural production, food security and rural development.

(ii) Medium-term:

- General training in HIV/AIDS-impact issues for politicians and departmental heads.

- Systematic analysis of the actual HIV/AIDS situation through regional and location-specific surveys using participatory data collection methods.

- Development, testing and promotion of labour-saving technologies and crops to be disseminated with the active participation of the rural communities through extension services, research stations, farmers' associations and NGOs.

- Promotion of animal breeds that require less care.

- Development and adaptation of appropriate extension messages containing explicit HIV/AIDS components, which provide solutions to the problems in HIV/AIDS-affected households identified in location-specific community-based participatory analysis of the situation and needs in specific communities.

- Promotion of income-generating activities for vulnerable groups (female-headed households, orphans and elderly farmers), for example, non-traditional livestock activities, such as beekeeping, small animal husbandry, poultry keeping, etc.

- Development of mitigation strategies to reinforce and expand the traditional coping mechanisms at household and community levels.

- Development of special support activities for AIDS widows assisting them to get access to support services and advise them on legal and inheritance issues.

(iii) Long-term:

The Ministry of Agriculture should develop a long-term plan to mitigate the consequences of HIV/AIDS in rural economies through the promotion of sustainable agricultural and rural development following a participatory approach that involves the relevant agencies, institutions and farmers.

4.3.2. Implementation and resource mobilization

National AIDS control programmes should include a broader spectrum of HIV/AIDS prevention and mitigation activities. Their coordination should be delegated to an institutionally integrated HIV/AIDS steering committee, which should be associated fully in the organization and management of the national AIDS control Program me The Ministry of Agriculture and other associated agencies should establish technical advisory committees on HIV/AIDS and agriculture/household food security advising the various departments/units as well as selected regional and district level agricultural offices/institutions on all HIV/AIDS related issues. In addition, each ministry or agency/institution should establish a monitoring unit, preferably in the planning department and designate a desk officer to organize and coordinate HIV/AIDS-related activities. Similarly, in the regional planning offices a specifically designated officer should be in charge of the coordination of HIV/AIDS activities, and the institutional capacity at regional and district levels should be strengthened to effectively monitor and coordinate HIV/AIDS-related activities.

The national AIDS control Program me will have to provide the collaborating ministries and agencies/institutions with additional budgetary resources for the development of an efficient HIV/AIDS action programme. A resource mobilization strategy will have to investigate possibilities to obtain technical assistance and financial resources from the international donors and relevant NGOs. The Joint United Nations Program me on HIV/AIDS (UNAIDS) can coordinate and advocate for maximum participation of community-based organizations, NGOs, bilateral donors, national agencies, universities, research institutions and other national and international partners who could potentially be involved in HIV/AIDS prevention and mitigation strategies/activities.

Conclusions

FAO was the first UN agency to initiate detailed sectoral analysis of the socio-economic impact of HIV/AIDS on rural economies. Thus, right from the beginning, FAO perceived the HIV/AIDS epidemic as a development problem of critical importance, rather than simply a health issue.

There seems to be growing consensus that the HIV/AIDS epidemic will not be contained as long as it is regarded as only a health sector issue and not placed within the overall context of development. A strong political commitment to fight the epidemic is necessary to enable a comprehensive and integrated approach to alleviate the widespread impact of the disease and to address issues of poverty and powerlessness. Many governments in sub-Saharan Africa are in the process of developing a national strategic plan for a multisectoral response to HIV/AIDS. This exercise has evolved with the assistance of the Global AIDS Program me (GPA/WHO) and is now followed up by the Joint United Nations Program me on HIV/AIDS (UNAIDS). In these plans each of the key sectors is assigned activities based on their comparative advantage. Ministries of agriculture need to participate in national AIDS control programmes and discuss with the authorities of other relevant sectors the role of agriculture in a multisectoral approach to HIV/AIDS.

In view of the rapid spread of the HIV/AIDS epidemic in rural areas, especially in sub-Saharan Africa, socio-economic and cultural research (through rapid assessment surveys) needs to be conducted on the impact of the disease on agricultural production systems, household food security, traditional coping mechanisms, etc. to enable the development of appropriate prevention and mitigation strategies. The following considerations and activities are suggested to launch joint HIV/AIDS prevention and mitigation strategies for rural households/communities:

* Research into the location-specific agricultural impact of the disease is necessary. For example, research may be directed towards the development of crops that require less labour but are nutritious, cultivation practices that are less labour-intensive and labour-saving conservation technologies.

* Agricultural education and training policies need to take account of the gender implications and the socio-economic impact of the epidemic on rural households/communities.

* National AIDS control programmes should advocate enactment/enforcement of legal reforms to protect vulnerable groups, especially HIV/AIDS widows and orphans, focusing on land tenure, inheritance, access to assistance and inputs.

* Specific population groups most affected by the disease must be targeted for education, training and assistance. Special attention should be given to girls who are taken out of school to work and take care of the family. Agricultural extension programmes need to collaborate with other technical agencies and relevant NGOs in specific areas to promote HIV/AIDS prevention campaigns complimented by problem-solving interventions for the most affected households and/or communities.

* Development agencies, especially agricultural extension and relevant NGOs, need to take account of the implications of HIV/AIDS in all their outreach activities. Rural development policies that take account of the effects of the disease can reduce its impact. Participatory and problem-solving extension programmes that improve farmers' social and economic conditions and reduce dependence on migration and prostitution will reduce transmission of the disease.

* Rural households and communities develop and adapt their own coping mechanisms. Agricultural extension programmes in collaboration with other agencies and NGOs should support and assist this process.

* Improvement in women's social and economic status is a crucial step for increasing their ability to protect themselves and their families and children from the epidemic. Gender-sensitive agricultural extension programmes can make an important contribution in this regard.

* Rural development policies in sub-Saharan Africa need to take account of the growing labour constraints and the potential widespread disruption to the rural economy and social structure.

* Whatever the extent of HIV infection in the population, governments need to undertake extensive awareness and education programmes. Low rates of infection provide an opportunity to effectively prevent the spread of the epidemic. High rates of infection require urgent measures.

* Whatever the extent of HIV infection in the population, governments need to provide an integrated response to the epidemic. National HIV/AIDS control programmes must be broad-based and involve all government and non-governmental agencies, including ministries of finance, health, agriculture, education, etc.

* Many countries have already established, under the coordination of UNAIDS, a UN-theme group on HIV/AIDS. The representatives of UNFPA and FAO should participate in this exercise and bring the issues of HIV/AIDS-related impact on agricultural production and rural households/communities before this theme group in order to define the role of the Ministry of Agriculture in an overall national strategic plan for HIV/AIDS prevention and mitigation.

* Technical assistance agencies, including FAO, should combine their efforts to improve the existing mitigation and prevention strategies to combat the disease in rural areas.

Key documents on HIV/AIDS and rural development

Ainsworth, M. 1993. The impact of HIV/AIDS on African development. AFTHR. Washington, DC, USA, World Bank.

Barnett, T. & Blaikie, P.M. 1992. AIDS in Africa: its present and future impact. London, UK, Belhaven Press.

Barnett, T. & Haslwimmer, M. 1995. The effects of HIV/AIDS on farming systems in eastern Africa. Rome, FAO.

Cohen, D. 1992. The economic impact of the HIV epidemic. New York, NY, USA, UNDP.

League of Red Cross and Red Crescent Societies. 1990. Action for youth. AIDS training manual. Geneva, IFRC.

Norse, D. 1991. "Socio-economic Impact of AIDS on Food Production in East Africa." Paper prepared for the VII International Conference on AIDS, Florence, Italy, 16-21 June 1991.

Over, M. 1992. The macroeconomic impact of AIDS in sub-Saharan Africa. Technical Working Paper No.3. World Bank Population Health and Nutrition Division. Washington, DC, USA, World Bank.

Panos Institute. The hidden cost of AIDS: the challenge of HIV to development. London, UK, Panos Institute.

Roseberry,W. 1995. AIDS prevention and mitigation in sub-Saharan Africa: an updated World Bank strategy. AFTHR. Washington, DC, USA, World Bank.

Topouzis, D. 1994. The socio-economic impact of HIV/AIDS on rural families with an emphasis on youth. Rome, FAO.

United Nations Population Fund. 1995. AIDS update 1994: a report on UNFPA support in the area of HIV/AIDS prevention. New York, NY, USA, UNFPA.

World Bank. 1992. Tanzania AIDS assessment and planning study. Washington, DC, USA, World Bank.

World Bank. 1994. HIV/AIDS activities. Population, Health and Nutrition Division. Washington, DC, USA, World Bank.

World Bank. 1995. Regional AIDS strategy for the Sahel. West Africa Division, Population and Human Resources Division. Washington, DC, USA, World Bank.

World Health Organization. 1995. Community HIV prevention handbook. Geneva, WHO.

World Health Organization. 1995. Youth, HIV infection and development in Africa. Tunis, WHO.

Annex I - UNAIDS, end 1996 global estimates

End 1996 global estimates

Annex II - FAO studies/activities on the socio-economic impact of HIV/AIDS on agriculture and rural development

FAO was the first UN agency to initiate detailed sectoral analysis of the socio-economic impact of HIV/AIDS on rural economies, and also pre-empted much of the work of this nature by independent institutions. FAO's actions were motivated by increasing evidence that the HIV/AIDS epidemic would intensify existing bottlenecks in agriculture, especially in sub-Saharan Africa; increase the widespread malnutrition; add to the problems of rural women, especially female-headed households arising from gender division of labour and land rights/resources; and deepen the debt crisis by reducing agricultural exports. Thus, right from the beginning, FAO perceived the HIV/AIDS epidemic as a development problem of critical importance, rather than simply a health issue.

Since 1988, FAO has undertaken three country case-studies in East Africa relying on the analysis of existing data to increase the understanding of the impacts of HIV/AIDS on agricultural production systems and rural development in general. These studies have been complemented by an assessment of the availability of data for similar case-studies in other countries in Central and southern Africa. These studies, which include surveys on labour allocation within families according to age and gender, labour requirements of different crops and patterns of farm income and expenditure, have identified both specific and general characteristics of vulnerable households and farming systems. They have also demonstrated the importance of home remittances from migrant workers and their loss from HIV/AIDS-related morbidity and mortality affecting household food security, food production and nutritional well-being.

Since 1993, FAO has concentrated its efforts on determining actual rather than hypothesized coping strategies in full-impact HIV/AIDS areas, with a view towards elaborating a comprehensive agenda for action that could be shaped by countries to meet their particular circumstances and needs.

The following projects/ activities have been undertaken or initiated:

(1) The Agricultural Extension and Education Service (SDRE), under FAO's Technical Cooperation Program me (TCP), financed and carried out the project TCP/UGA/2256 "Strengthening Programmes for Rural Youth in Uganda". This project became operational in April 1993 and was the first initiative to address the HIV/AIDS epidemic within Uganda's Ministry of Agriculture, Animal Industries and Fisheries (MAAIF). The major trust of the project, which came to an end in early 1995, was to address the situation and needs of rural youth and to strengthen the Extension Service's Young Farmers Program me and, also, in view of the magnitude of the HIV/AIDS epidemic in Uganda, to assess the socio-economic impact of HIV/AIDS on rural families and develop the framework for an HIV/AIDS component for the

Young Farmers Program me (YFP). A five-month consultancy was added to assess the impact of HIV/AIDS on rural families, young people in rural areas and agricultural production. The report, "Socio-economic Impact of HIV/AIDS on Rural Families with an Emphasis on Youth", was finalized in February 1994. One of the conclusions of the study was that HIV/AIDS is having an adverse effect on the already overburdened and under-resourced agricultural extension service. Highly qualified civil servants and technocrats are increasingly dying of AIDS and are not being replaced. In some districts agricultural programmes cannot be implemented as a result of HIV/AIDS: extension staff are frequently attending funerals. HIV/AIDS interventions targeting rural youths through the agricultural extension service may be ineffective, without appropriate measures to strengthen the extension service.

(2) Under Technical Support Services (TSS-1) arrangements with UNDP, FAO carried out a comprehensive study, "The Effect of HIV/AIDS on Agricultural Production Systems in Eastern Africa (Tanzania, Uganda, Zambia)". The study focused on three main objectives: the identification of vulnerable farming systems/household types; determination of possible impacts, both quantitative and qualitative; and formulation of response options at the farm, community, national and international levels.

National multidisciplinary research teams were selected to carry out the HIV/AIDS impact studies in each of the three countries. Special emphasis was laid on qualitative data gathering methods derived from rapid rural appraisal (RRA) and participatory rural appraisal (PRA). The final report, "The Effects of HIV/AIDS on Farming Systems and Rural Livelihoods in Uganda, Tanzania and Zambia", was issued in February 1994 and provides a summary of the three country studies, including project and Program me recommendations, and outlines a framework for future activities.

As a result of the TCP study in Uganda and the East Africa TSS-1 activity, a booklet entitled "What has AIDS to do with Agriculture?" was produced in February 1995. The publication The effects of HIV/AIDS on farming systems in eastern Africa, FAO 1995, tries to bring to the attention of a wider audience some of the major ways in which serious and fatal epidemic illnesses are currently affecting rural populations in eastern Africa.

(3) Following these activities in eastern Africa, a TSS-1 proposal for West Africa was prepared by FAO. It has recently been approved by UNDP and preliminary work is being initiated. The project will entail field investigations in Côte d'Ivoire and Burkina Faso using a methodology with a strong emphasis on participation of the rural communities. Focus will be on exploratory survey techniques, such as rapid rural appraisal (RRA) and particularly participatory rapid appraisal (PRA), to enable the generation of appropriate qualitative information. Investigations will focus on the effects of HIV/AIDS on agriculture in Burkina Faso and Côte d'Ivoire, but will follow a gender-sensitive approach, by assessing the different needs and pastoral labour migration strategies for women and men, as HIV/AIDS affects both men and women in rural areas. Both countries are bound together by shared borders and have very strong migration ties, Burkina Faso being one of the poorest and least-developed countries, while Côte d'Ivoire is one of the most affluent countries in West Africa. The TSS-1 studies in Eastern and Western Africa did not cover the impact of HIV/AIDS on the pastoral population. As the pastoralists form an important part of Burkinabe population, a specific study with a particular approach is required to analyze the impact of the epidemic on the livelihood of pastoralists.

(4) In view of growing evidence of the devastating effects of the HIV/AIDS epidemic on agricultural production systems and thus on agricultural extension programmes in many developing countries, SDRE envisages possible studies and training activities related to the HIV/AIDS pandemic, with focus on its implications/consequences on agricultural extension programmes. .

A workshop, "AIDS and its Implications for Agricultural Extension", which was supported by FAO/SDRE's Regular Program me funds was successfully conducted in Penang, Malaysia, from 4 to 8 December 1995. This workshop was attended by 27 participants from various agricultural extension agencies, training institutions, universities, and non-governmental organizations from Italy, Kenya, Malawi, Malaysia, Nepal, the Philippines, Thailand and the United States. During the workshop, participants discussed the problems related to HIV/AIDS in various countries and its impact on agricultural development and production, as well as rural families and community welfare. In small working group sessions, the participants developed (a) the list of critical HIV/AIDS issues that are relevant to agricultural extension and training, and (b) the Critical Information and/or Technology Acquisition Package (CITAP) on HIV/AIDS and its implications for agricultural extension and training. Based on (a) and (b), the workshop participants then developed a suggested generic, prototype Knowledge, Attitude and Practice (KAP) survey questionnaire on AIDS and its implications for agricultural extension (AIDSIMAX).

As a result of the workshop's discussions, written summary proposals for conducting KAP surveys on HIV/AIDS and its Implications for Agricultural Extension (AIDSIMAX) were prepared by the Ministries of Agriculture in Malawi and Kenya, the Philippines Rural Reconstruction Movement, the Central Agriculture Training contra and the Thai Royal Project Foundation, Thailand.

The KAP survey, including the Focus Group Interviews (FGI) will initially be undertaken in North Malaysia in the MUDA Agricultural Development Authority (MADA) area with funding from FAO/SDRE. The results of the KAP survey will then be used as inputs for developing Strategic Extension Campaign (SEC) plans, messages and multimedia materials, as well as in determining the specific contents of and developing the HIV/AIDS prevention and coping mechanisms training curriculum and modules/materials for use by agricultural extension planners and trainers: the generic and prototype KAP survey questionnaire will be adapted and translated by the interested institutions that intend to undertake similar agricultural extension and training activities on HIV/AIDS such as in Malaysia. FAO/SDRE is now in the process of reviewing the proposals submitted by interested institutions in Kenya, Malawi, Nepal, the Philippines and Thailand.

It is hoped that funds will be made available through the UNFPA Country Program me in these countries to undertake the KAP surveys on AIDSIMAX and its follow-up activities, including the development of AIDS education training modules and strategic extension campaign (SEC) materials for rural outreach and/or agricultural extension workers.

(5) With regard to the investment side of the Organization's services, the Investment contra Division of FAO has been looking into how HIV/AIDS concerns can be integrated into its work. A "Discussion Paper on the Implications of HIV/AIDS on Investment contra Work" has been prepared and the recommendations are under review. In 1994, at IFAD's request, the Investment contra prepared an Orphan Assistance Project with a budget of US$ 1.45 million to be financed by a grant from the Belgian Survival Fund to the Uganda Women's Effort to Save Orphans (UWESO). The project has been approved, and its primary objective is to strengthen the capacity of UWESO to help the increasing number of orphans and orphan families resulting from regional wars and AIDS. The project supports primary-school scholarships, vocational training for orphans, income-generating activities, small grants to purchase agricultural tools and seeds, etc.

(6) FAO has also established a Working Group on AIDS, which is focusing on the preparation of educational initiatives for all groups of staff within FAO, including family members and consultants. The main purposes are to raise awareness beyond the health aspects and the potential impact of HIV/AIDS on the individual health status of staff and to include the socio-economic impact of the disease on agriculture and the potential effects on the work of the Organization. Since 1994, this Working Group on AIDS has been responsible for the preparation of the World AIDS Day, which is commemorated every year worldwide on l December.

On the basis of the findings of FAO's studies and activities, a section on AIDS and agriculture was included in the 1994 edition of The State of Food and Agriculture and debated by the 107th session of the FAO Council in November 1994. This session was the first such meeting to address the issue of HIV/AIDS and regretted the global incidence and spread of the HIV/AIDS virus which is not just a health issue, but also had adverse implications for agriculture and food security. The Council urged FAO "to continue monitoring the HIV/AIDS problem and to cooperate as appropriate with WHO and other agencies in assessing the adverse effects on food security and develop a preventive Programme for the benefit of women in agriculture".