Multiple stressors in Southern Africa: the link between HIV/AIDS, food insecurity, poverty and children's vulnerability now and in the future

AIDS Care. 2009;21 Suppl 1(S1):28-33. doi: 10.1080/09540120902942931.

Abstract

Several countries in Southern Africa now see large numbers of their population barely subsisting at poverty levels in years without shocks, and highly vulnerable to the vagaries of the weather, the economy and government policy. The combination of HIV/AIDS, food insecurity and a weakened capacity for governments to deliver basic social services has led to the region experiencing an acute phase of a long-term emergency. "Vulnerability" is a term commonly used by scientists and practitioners to describe these deteriorating conditions. There is particular concern about the "vulnerability" of children in this context and implications for children's future security. Through a review of literature and recent case studies, and using a widely accepted conceptualisation of vulnerability as a lens, we reflect on what the regional livelihoods crisis could mean for children's future wellbeing. We argue that an increase in factors determining the vulnerability of households - both through greater intensity and frequency of shocks and stresses ("external" vulnerability) and undermined resilience or ability to cope ("internal" vulnerability) - are threatening not only current welfare of children, but also their longer-term security. The two specific pathways we explore are (1) erosive coping strategies employed by families and individuals; and (2) their inability to plan for the future. We conclude that understanding and responding to this crisis requires looking at the complexity of these multiple stressors, to try to comprehend their interconnections and causal links. Policy and programme responses have, to date, largely failed to take into account the complex and multi-dimensional nature of this crisis. There is a misfit between the problem and the institutional response, as responses from national and international players have remained relatively static. Decisive, well-informed and holistic interventions are needed to break the potential negative cycle that threatens the future security of Southern Africa's children.

MeSH terms

  • Acquired Immunodeficiency Syndrome / economics
  • Acquired Immunodeficiency Syndrome / epidemiology*
  • Acquired Immunodeficiency Syndrome / ethnology
  • Adolescent
  • Africa, Southern / epidemiology
  • Child
  • Child Welfare* / economics
  • Child Welfare* / ethnology
  • Child Welfare* / statistics & numerical data
  • Child, Preschool
  • Delivery of Health Care* / economics
  • Delivery of Health Care* / organization & administration
  • Delivery of Health Care* / statistics & numerical data
  • Family Characteristics
  • Female
  • Food Supply* / economics
  • Food Supply* / statistics & numerical data
  • HIV Seropositivity / economics
  • HIV Seropositivity / epidemiology*
  • HIV Seropositivity / ethnology
  • Health Policy
  • Health Services Accessibility* / economics
  • Health Services Accessibility* / statistics & numerical data
  • Health Services Needs and Demand
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Poverty*
  • Vulnerable Populations*