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The role of labour in household food security: implications of AIDS in Africa
Food Policy 1994 19 (6) 56&573
Viewpoint
The role of labour in household food security: implications of AIDS in Africa’ Lynn R. Brown, Patrick Webb and Lawrence Haddad IFPRI, 1200 Seventeenth
Street, N. W., Washington,
DC200363006,
USA
In increasingly diversified and liberalized economies, understanding the potential for, and constraints to, achieving food security through the labour market is as important for food policy design as understanding the food market. In economies severely affected by AIDS, which impacts directly on labour supply, productivity and options, understanding the paths by which the disease may compromise food security at both household and national levels is crucial to making informed decisions about the allocation of scarce public resources. Keywords:
household
labour,
public resource
allocation,
food security
Purchasing power constraints, associated with a lack of income diversification opportunities, are central to household food insecurity. A heavy dependence on agriculture limits a household’s options for coping with external shocks, as well as for securing economic growth. Diversification of income sources through entry into the labour market generally helps to protect household income and food consumption levels. In many parts of Sub-Saharan Africa, non-farm sources have been found to provide an average of 58 per cent of total income in rural households (von Braun and Pandya-Larch, 1991). Artisanal work, wage employment, commerce, transfers and the sale of collected fuel all contribute to rural non-farm household income. These sources have greater importance in areas where agriculture is more risky (vulnerability to drought), and allow households to stabilize their income streams and consumption. Failure to secure income from such sources during crises (such as famine) can result in a dramatic decline in already low levels of food consumption among the poor. The AIDS pandemic represents one such crisis. When household labour supply is disrupted through increased morbidity and/or mortality, farm productivity declines as does non-farm income. This paper focuses on the potential effect of labour constraints on household food security as measured by income levels and sources, food consumption and nutrition status. The paper also draws attention to the possible trade-offs facing policymakers and donors in the allocation of public resources to counter the AIDS threat. The drain of resources out of ‘soft’ budget lines, such as agricultural
‘Paper prepared for the Symposium on the Impacts of Aids on Food Security international agricultural economics meetings in Zimbabwe, August 1994.
568
0306-9192/94/060568-06
0
in Africa,
for the
1994 Butterworth-Heinemann
Ltd
The role of labour in food security: L. R. Brown et al.
research and extension, in order to cover the costs of AIDS carries important longer-term implications for national-level
care in urban centres food security.
Definitions Food security is defined here as availability of food, access to food, and risks related to either availability or access. At the household level, food security represents the ability of the household to secure enough food to ensure adequate dietary intake for all of its members (von Braun et al., 1992). Thus, while availability of food is a necessary condition for food security, it is by no means a sufficient condition. Food insecurity can be classified as either transitory or chronic. Transitory food insecurity is a temporary decline in access to food due to factors such as instability of food prices, production or incomes (World Bank, 1986). Chronic food insecurity, a persistently inadequate diet caused by a continual inability of households to acquire needed food either through production or market purchase, is rooted in poverty. AIDS has an impact on people’s labour at several levels: supply, productivity and opportunities. Poor households are characterized by an overwhelming reliance on labour as their sole factor of production and income generation. Poverty and food security are inextricably linked. Factors which diminish labour quantity and/or quality will increase the incidence and depth of household poverty. Factors which exacerbate poverty also exacerbate problems of food insecurity, driving the transitory food insecure towards chronic food insecurity and previously food secure households towards transitory or even chronic food insecurity. HIV affects adults in their prime productive years in all socio-economic groups. In Africa, when estimated in terms of discounted productive healthy years of life lost per capita, HIV infection ranks among the top five health problems in urban populations with moderate to high HIV prevalence rates (seroprevalance rates greater than 3 per cent). HIV infection also has a knock-on impact on other endemic diseases, such as tuberculosis, the incidence of which has shown substantial increases in several countries, such as Malawi, Tanzania and Uganda (Lamboray and Elmendorf, 1992). This knock-on effect leads to lower levels of labour supply and productivity through increased morbidity.
Conceptual framework The labour equation presented below provides a framework for analysing the impact of AIDS on income per person at the household level. This framework, adapted from Lipton (1983), decomposes income per household member into household endowments of labour, labour force participation, labour diversification, average supply and average labour productivity. The five components are described below in more detail. hh. income
=
tot. persons X
Wrkg persons
x Wrkforce Participants
total persons working persons no. of activities x hrs worked wrkforce
participants
Household labour endowment. This pendency ratio. As the dependency Food Policy 1994 Volume 19 Number 6
no. activities
x
income hrs. wrkd
is inversely related to the household’s deratio increases, household relative labour 569
The role of labour in food security: L. R. Brown et al.
endowment declines at an increasing rate. HIV strikes at individuals in their prime productive years. Thus the most direct impact on income is the loss of working age persons. AIDS also raises the dependency ratio of families not directly afflicted by HIV through informal social security systems that result in the adoption of children, orphaned as a result of AIDS, in other households. The impact on poor households, due to loss of productive workers or additional dependents, is relatively greater as they are already characterized by high dependency ratios (Haddad et al., 1992). with poverty, with the Household labour force participation. This increases exception of ultra-poor households, where health and nutrition constraints reduce labour participation (Lipton, 1983). AIDS has a negative impact on the participation rate both through direct channels, such as the death of a worker, and indirect channels, such as a household member switching out of the formal labour force to a domestic caring role. Faced with falling incomes households attempt to increase their labour force participation. This can result in additional women and younger members of the household entering the workforce, with potentially negative outcomes on child care, household nutritional status, and long run human capital formation, thereby diminishing long-run productivity. An issue of concern is that poor households already have high labour force participation rates and therefore the potential margin of adjustment is small. Labour diversification. This is important to achieve income security, critical for food security, particularly in rural areas (Von Braun and Pandya Larch, 1991; Reardon et al., 1993). In risky agricultural climates, households with more diversified off-farm income are less vulnerable to food insecurity (Reardon et al., 1992). Households with few members in the labour force are less able to diversify their income streams. Loss of a prime worker, particularly the male head, may result in the loss of more than one income-earning activity. Indirect effects may also be felt by other household members who reduce their number of activities in order to provide a caring role. Remaining working members of the household, and those newly drawn into the labour force, may be unable to pick up foregone activities because of access constraints (loss of access to land when a male household head dies, or lack of credit access), or because of their labour is unsuitable (loss of male labour prohibits some heavy manual work). Diversification constraints are also important for urban households. Urbanization appears to cut female workforce participation even among the poor (World Bank, 1989). The lower educational status of women, combined with child-care, reduces their ability to participate as fully in the workforce as in rural areas. Average labour supply, This declines as workers become sick or are obliged to devote time to a caring role. In Ghana, the effect of losing a day’s activity per month due to disabling morbidity was to reduce monthly labour supply by 12 per cent for men (Schultz and Tansel, 1993). There is pressure on other household members to increase labour supply in order to compensate. However, where feasible, poor households already demonstrate high labour supply levels and thus the scope for increased adjustment is small. Labour productivity. This declines as morbidity increases. In Cote D’Ivoire, for example, the effect of a disabling day of morbidity, in a month, is to reduce male wage rates by 15 per cent which combined with labour supply reduction reduces 570
Food Policy 1994 Volume 19 Number 6
The role of labour in food security: L. R. Brown et al.
monthly earnings by 29 per cent (Schultz and Tansel, 1993). HIV strikes workers in their most productive years, it is the most productive labour which is lost, and this results in even greater declines in income. AIDS does not appear to be concentrated in any particular socio-economic status, except perhaps in urban areas where incidence has been found to be positively correlated with higher socio-economic status and education levels (Traore, 1991a, 1991b). Currently, the impact of AIDS on productivity could be argued to be greatest through reductions in the return on previous expensive educational investments by society.
Policy implications
and conclusions
One of the most important impacts of AIDS (aside from raising mortality rates), is the exacerbation of poverty and the reduction in the household’s ability to cope with shocks, Currently, the impact of AIDS is perceived to be greatest in urban areas, where it is the leading cause of male mortality and the second leading cause of female adult mortality for some African countries. Isolated rural communities have been relatively less vulnerable, at least in the short-run. Trade links appear to be important conduits for the spread of infection (Brown, 1990; Okware, 1987). Rural communities most at risk are those which have the greatest marketing and infrastructural linkages to urban areas. These links exist because these rural areas were those of greatest agricultural potential. Thus they produce the largest agricultural surplus and constitute the major supply component in national food supply. As AIDS impacts on rural areas, households facing reduced incomes and labour availability may change their crop patterns and reduce purchased inputs such as fertilizers, resulting in declining yields. The food supply chain is therefore directly vulnerable to the AIDS pandemic in the medium term. The predominance of AIDS in urban sectors, and its incidence among those of high socio-economic status, give impetus to lobbies seeking a stronger public response to AIDS. This is likely to lead to the allocation of more resources to AIDS alleviation than if the pandemic had been purely a problem associated with the poor. Currently, almost half of all hospital beds in Abidjan and other major cities in central and eastern Africa are occupied by AIDS patients (Lamboray and Elmendorf, 1992). If all AIDS patients in Tanzania were to receive care from the formal health infrastructure, such care would consume approximately 50 per cent of the recurrent health care budget for a year. But, health budgets are already strained. Given limited resources, demands for increases in health care expenditure, and a realignment in social service sector spending towards urban health care, could have severe implications for national food security. Increases in health care expenditures are likely to come not only from social sector spending realignments but also from cutbacks in other sectors. Government expenditure is most likely to be cut in areas perceived to have less immediate and visible benefits. This raises the vulnerability of agricultural research and extension - crucial areas for improvements in long run food security through increased food supply. For example, although high rates of return (between 20 and 40 per cent) have been documented for investments in agricultural research during the 1980s and early 1990s international assistance by donors to developing country agriculture has declined sharply. Funding by the United States was less than one half (in real terms) than it had been in 1988 (von Braun et al., 1993). A similar, though less dramatic decline was posted by the World Bank (a decline of 25 per cent over the Food Policy 1994 Volume 19 Number 6
571
The role of labour in food security: L. R. Brown et al.
same period). In 1994, funding for the Consultative Group on International Agricultural Research - the driving force behind the Green Revolution - is likely to be 27 per cent below its level of funding for 1990 in real terms. This is unfortunate, since there is a real time lag between agricultural research and increased production. The adequacy of current food supplies is a testimony to past investments in agricultural research. It may take 10 years or longer for the impact of new technologies or support services to be realized in the agricultural sector. While mortality rates may rise due to AIDS related deaths, the effects are predicted to be moderate, resulting in as little as a 1 per cent decline in annual population growth rates (Bongaarts, 1988). Given current high population growth rates in many African countries, this is unlikely to have substantial impact on food demand. However, food availability could be affected at a household level by labour loss, and at a national level through increased demands on public resources that result in a starvation of agricultural investment. Household food security will be severely undermined in households affected by AIDS. All households affected will suffer from reductions in household income due to a declining household labour endowment. For households already vulnerable to food insecurity, the impact will be even greater, reducing their ability to cope with other shocks through labour mediated coping mechanisms. However, as the impact of AIDS is felt in high productivity agricultural regions the national food supply chain will also be at risk. These impacts will be magnified if governments sacrifice investment today in primary rural health care, education, agricultural research, and extension, all of which jeopardize future agricultural yield increases. Recognition that the incidence of HIV is rising rapidly across Africa has given it a new and major focus for many governments and donor agencies. Yet, it would be short-sighted to approach the pandemic as simply another health problem. The implications for continent-wide food security are potentially huge.
References Barnett, A and Blaikie, P (1992) AIDS in Africa, Guilford Press, London Bongaarts, J (1988) ‘Modelling the demographic impact of AIDS in Africa’ AAS Symposium paper (R Kulstad, ed) Brown, P (1990) ‘Africa’s growing AIDS crisis’ New Scientist, 17 November, p 41 Haddad, L, Sullivan, J and Kennedy, E (1992) Zdentification and evaluation of alternative indicators of food and nutrition security: some conceptual issues and an analysis of extant data, International Food Policy Research Institute Mimeo, Washington, DC Laboray, J-L and Elmendorf, A E (1992) Combatting AIDS and other sexually transmitted diseases in paper, Africa Africa: A review of the World Bank’s agenda for action, World Bank Discussion Technical Dem. No. 181, World Bank, Washington, DC Lipton, M (1983) Labour and poverty, Staff Working Paper No. 616, World Bank, Washington, DC Okware, S I (1987) ‘Towards a national AIDS control program in Uganda’ The Western Journal of Medicine, 146, Part 6, pp 726-729 Reardon, T, Abdoulaye, A, Kelly, V, Delgado, C, Matlon, P, Hopkins, J and Badiane, 0 (1993) ‘Anriculture-led income diversification in the west African semi-arid tropics: Nature, distribution, and importance of production-linkage activities’ in A Atsain, S Wangwe and A G Drabek (eds.), African Economic Issues (forthcoming) Reardon, T, Delgado, C and Matlon, P (1992) ‘Determinants and effects of income diversification amongst farm households in Burkina Faso’ Journal of Development Studies Schultz, T P and Tansel, A (1993) Measurement of returns to adult health. Morbidity effects on wage rates in Cote D’lvoire and Ghana, Living Standards Measurement Survey Working Paper No. 95, World Bank, Washington, DC Traore, A (1991a) ‘The cost of AIDS: food for thought’ The Courier, No 126, pp 47-49
572
Food Policy 1994 Volume 19 Number 6
The role of labour in food security: L. R. Brown et al. Traore, A (1991b) ‘Interview with Dr. Michael Merson: We have to think of AIDS as a development problem, not just a health one’ The Courier, No 126, pp 5G52 von Braun, J, Bouis, H, Kumar, S and Pandya-Larch, R (1992) Improving food security for the poor. Concept, policy and programs, International Food Policy Research Institute Occasional Paper, Washington, DC von Braun, J, Hopkins, R, Puetz, D and Pandya-Larch, R (1993) Aid to agriculture: Reversing fhe decline, International Food Policy Research Institute Food Policy Report, Washington DC von Braun, J and Pandya-Larch, R (1991) Income sources of the malnourished people in rural areas: Microlevel information and policy implications, Working Paper No. 5 on Commercialization of Agriculture and Nutrition, International Food Policy Research Institute Food Policy Report, Washington, DC World Bank (1989) India, Poverty, Employment, and Social Services, World Bank Country Study, Washington, DC World Bank (1986) Povero and Hunger, World Bank Policy Study, Washington, DC
Food Policy 1994 Volume 19 Number 6
573
Viewpoint
The role of labour in household food security: implications of AIDS in Africa’ Lynn R. Brown, Patrick Webb and Lawrence Haddad IFPRI, 1200 Seventeenth
Street, N. W., Washington,
DC200363006,
USA
In increasingly diversified and liberalized economies, understanding the potential for, and constraints to, achieving food security through the labour market is as important for food policy design as understanding the food market. In economies severely affected by AIDS, which impacts directly on labour supply, productivity and options, understanding the paths by which the disease may compromise food security at both household and national levels is crucial to making informed decisions about the allocation of scarce public resources. Keywords:
household
labour,
public resource
allocation,
food security
Purchasing power constraints, associated with a lack of income diversification opportunities, are central to household food insecurity. A heavy dependence on agriculture limits a household’s options for coping with external shocks, as well as for securing economic growth. Diversification of income sources through entry into the labour market generally helps to protect household income and food consumption levels. In many parts of Sub-Saharan Africa, non-farm sources have been found to provide an average of 58 per cent of total income in rural households (von Braun and Pandya-Larch, 1991). Artisanal work, wage employment, commerce, transfers and the sale of collected fuel all contribute to rural non-farm household income. These sources have greater importance in areas where agriculture is more risky (vulnerability to drought), and allow households to stabilize their income streams and consumption. Failure to secure income from such sources during crises (such as famine) can result in a dramatic decline in already low levels of food consumption among the poor. The AIDS pandemic represents one such crisis. When household labour supply is disrupted through increased morbidity and/or mortality, farm productivity declines as does non-farm income. This paper focuses on the potential effect of labour constraints on household food security as measured by income levels and sources, food consumption and nutrition status. The paper also draws attention to the possible trade-offs facing policymakers and donors in the allocation of public resources to counter the AIDS threat. The drain of resources out of ‘soft’ budget lines, such as agricultural
‘Paper prepared for the Symposium on the Impacts of Aids on Food Security international agricultural economics meetings in Zimbabwe, August 1994.
568
0306-9192/94/060568-06
0
in Africa,
for the
1994 Butterworth-Heinemann
Ltd
The role of labour in food security: L. R. Brown et al.
research and extension, in order to cover the costs of AIDS carries important longer-term implications for national-level
care in urban centres food security.
Definitions Food security is defined here as availability of food, access to food, and risks related to either availability or access. At the household level, food security represents the ability of the household to secure enough food to ensure adequate dietary intake for all of its members (von Braun et al., 1992). Thus, while availability of food is a necessary condition for food security, it is by no means a sufficient condition. Food insecurity can be classified as either transitory or chronic. Transitory food insecurity is a temporary decline in access to food due to factors such as instability of food prices, production or incomes (World Bank, 1986). Chronic food insecurity, a persistently inadequate diet caused by a continual inability of households to acquire needed food either through production or market purchase, is rooted in poverty. AIDS has an impact on people’s labour at several levels: supply, productivity and opportunities. Poor households are characterized by an overwhelming reliance on labour as their sole factor of production and income generation. Poverty and food security are inextricably linked. Factors which diminish labour quantity and/or quality will increase the incidence and depth of household poverty. Factors which exacerbate poverty also exacerbate problems of food insecurity, driving the transitory food insecure towards chronic food insecurity and previously food secure households towards transitory or even chronic food insecurity. HIV affects adults in their prime productive years in all socio-economic groups. In Africa, when estimated in terms of discounted productive healthy years of life lost per capita, HIV infection ranks among the top five health problems in urban populations with moderate to high HIV prevalence rates (seroprevalance rates greater than 3 per cent). HIV infection also has a knock-on impact on other endemic diseases, such as tuberculosis, the incidence of which has shown substantial increases in several countries, such as Malawi, Tanzania and Uganda (Lamboray and Elmendorf, 1992). This knock-on effect leads to lower levels of labour supply and productivity through increased morbidity.
Conceptual framework The labour equation presented below provides a framework for analysing the impact of AIDS on income per person at the household level. This framework, adapted from Lipton (1983), decomposes income per household member into household endowments of labour, labour force participation, labour diversification, average supply and average labour productivity. The five components are described below in more detail. hh. income
=
tot. persons X
Wrkg persons
x Wrkforce Participants
total persons working persons no. of activities x hrs worked wrkforce
participants
Household labour endowment. This pendency ratio. As the dependency Food Policy 1994 Volume 19 Number 6
no. activities
x
income hrs. wrkd
is inversely related to the household’s deratio increases, household relative labour 569
The role of labour in food security: L. R. Brown et al.
endowment declines at an increasing rate. HIV strikes at individuals in their prime productive years. Thus the most direct impact on income is the loss of working age persons. AIDS also raises the dependency ratio of families not directly afflicted by HIV through informal social security systems that result in the adoption of children, orphaned as a result of AIDS, in other households. The impact on poor households, due to loss of productive workers or additional dependents, is relatively greater as they are already characterized by high dependency ratios (Haddad et al., 1992). with poverty, with the Household labour force participation. This increases exception of ultra-poor households, where health and nutrition constraints reduce labour participation (Lipton, 1983). AIDS has a negative impact on the participation rate both through direct channels, such as the death of a worker, and indirect channels, such as a household member switching out of the formal labour force to a domestic caring role. Faced with falling incomes households attempt to increase their labour force participation. This can result in additional women and younger members of the household entering the workforce, with potentially negative outcomes on child care, household nutritional status, and long run human capital formation, thereby diminishing long-run productivity. An issue of concern is that poor households already have high labour force participation rates and therefore the potential margin of adjustment is small. Labour diversification. This is important to achieve income security, critical for food security, particularly in rural areas (Von Braun and Pandya Larch, 1991; Reardon et al., 1993). In risky agricultural climates, households with more diversified off-farm income are less vulnerable to food insecurity (Reardon et al., 1992). Households with few members in the labour force are less able to diversify their income streams. Loss of a prime worker, particularly the male head, may result in the loss of more than one income-earning activity. Indirect effects may also be felt by other household members who reduce their number of activities in order to provide a caring role. Remaining working members of the household, and those newly drawn into the labour force, may be unable to pick up foregone activities because of access constraints (loss of access to land when a male household head dies, or lack of credit access), or because of their labour is unsuitable (loss of male labour prohibits some heavy manual work). Diversification constraints are also important for urban households. Urbanization appears to cut female workforce participation even among the poor (World Bank, 1989). The lower educational status of women, combined with child-care, reduces their ability to participate as fully in the workforce as in rural areas. Average labour supply, This declines as workers become sick or are obliged to devote time to a caring role. In Ghana, the effect of losing a day’s activity per month due to disabling morbidity was to reduce monthly labour supply by 12 per cent for men (Schultz and Tansel, 1993). There is pressure on other household members to increase labour supply in order to compensate. However, where feasible, poor households already demonstrate high labour supply levels and thus the scope for increased adjustment is small. Labour productivity. This declines as morbidity increases. In Cote D’Ivoire, for example, the effect of a disabling day of morbidity, in a month, is to reduce male wage rates by 15 per cent which combined with labour supply reduction reduces 570
Food Policy 1994 Volume 19 Number 6
The role of labour in food security: L. R. Brown et al.
monthly earnings by 29 per cent (Schultz and Tansel, 1993). HIV strikes workers in their most productive years, it is the most productive labour which is lost, and this results in even greater declines in income. AIDS does not appear to be concentrated in any particular socio-economic status, except perhaps in urban areas where incidence has been found to be positively correlated with higher socio-economic status and education levels (Traore, 1991a, 1991b). Currently, the impact of AIDS on productivity could be argued to be greatest through reductions in the return on previous expensive educational investments by society.
Policy implications
and conclusions
One of the most important impacts of AIDS (aside from raising mortality rates), is the exacerbation of poverty and the reduction in the household’s ability to cope with shocks, Currently, the impact of AIDS is perceived to be greatest in urban areas, where it is the leading cause of male mortality and the second leading cause of female adult mortality for some African countries. Isolated rural communities have been relatively less vulnerable, at least in the short-run. Trade links appear to be important conduits for the spread of infection (Brown, 1990; Okware, 1987). Rural communities most at risk are those which have the greatest marketing and infrastructural linkages to urban areas. These links exist because these rural areas were those of greatest agricultural potential. Thus they produce the largest agricultural surplus and constitute the major supply component in national food supply. As AIDS impacts on rural areas, households facing reduced incomes and labour availability may change their crop patterns and reduce purchased inputs such as fertilizers, resulting in declining yields. The food supply chain is therefore directly vulnerable to the AIDS pandemic in the medium term. The predominance of AIDS in urban sectors, and its incidence among those of high socio-economic status, give impetus to lobbies seeking a stronger public response to AIDS. This is likely to lead to the allocation of more resources to AIDS alleviation than if the pandemic had been purely a problem associated with the poor. Currently, almost half of all hospital beds in Abidjan and other major cities in central and eastern Africa are occupied by AIDS patients (Lamboray and Elmendorf, 1992). If all AIDS patients in Tanzania were to receive care from the formal health infrastructure, such care would consume approximately 50 per cent of the recurrent health care budget for a year. But, health budgets are already strained. Given limited resources, demands for increases in health care expenditure, and a realignment in social service sector spending towards urban health care, could have severe implications for national food security. Increases in health care expenditures are likely to come not only from social sector spending realignments but also from cutbacks in other sectors. Government expenditure is most likely to be cut in areas perceived to have less immediate and visible benefits. This raises the vulnerability of agricultural research and extension - crucial areas for improvements in long run food security through increased food supply. For example, although high rates of return (between 20 and 40 per cent) have been documented for investments in agricultural research during the 1980s and early 1990s international assistance by donors to developing country agriculture has declined sharply. Funding by the United States was less than one half (in real terms) than it had been in 1988 (von Braun et al., 1993). A similar, though less dramatic decline was posted by the World Bank (a decline of 25 per cent over the Food Policy 1994 Volume 19 Number 6
571
The role of labour in food security: L. R. Brown et al.
same period). In 1994, funding for the Consultative Group on International Agricultural Research - the driving force behind the Green Revolution - is likely to be 27 per cent below its level of funding for 1990 in real terms. This is unfortunate, since there is a real time lag between agricultural research and increased production. The adequacy of current food supplies is a testimony to past investments in agricultural research. It may take 10 years or longer for the impact of new technologies or support services to be realized in the agricultural sector. While mortality rates may rise due to AIDS related deaths, the effects are predicted to be moderate, resulting in as little as a 1 per cent decline in annual population growth rates (Bongaarts, 1988). Given current high population growth rates in many African countries, this is unlikely to have substantial impact on food demand. However, food availability could be affected at a household level by labour loss, and at a national level through increased demands on public resources that result in a starvation of agricultural investment. Household food security will be severely undermined in households affected by AIDS. All households affected will suffer from reductions in household income due to a declining household labour endowment. For households already vulnerable to food insecurity, the impact will be even greater, reducing their ability to cope with other shocks through labour mediated coping mechanisms. However, as the impact of AIDS is felt in high productivity agricultural regions the national food supply chain will also be at risk. These impacts will be magnified if governments sacrifice investment today in primary rural health care, education, agricultural research, and extension, all of which jeopardize future agricultural yield increases. Recognition that the incidence of HIV is rising rapidly across Africa has given it a new and major focus for many governments and donor agencies. Yet, it would be short-sighted to approach the pandemic as simply another health problem. The implications for continent-wide food security are potentially huge.
References Barnett, A and Blaikie, P (1992) AIDS in Africa, Guilford Press, London Bongaarts, J (1988) ‘Modelling the demographic impact of AIDS in Africa’ AAS Symposium paper (R Kulstad, ed) Brown, P (1990) ‘Africa’s growing AIDS crisis’ New Scientist, 17 November, p 41 Haddad, L, Sullivan, J and Kennedy, E (1992) Zdentification and evaluation of alternative indicators of food and nutrition security: some conceptual issues and an analysis of extant data, International Food Policy Research Institute Mimeo, Washington, DC Laboray, J-L and Elmendorf, A E (1992) Combatting AIDS and other sexually transmitted diseases in paper, Africa Africa: A review of the World Bank’s agenda for action, World Bank Discussion Technical Dem. No. 181, World Bank, Washington, DC Lipton, M (1983) Labour and poverty, Staff Working Paper No. 616, World Bank, Washington, DC Okware, S I (1987) ‘Towards a national AIDS control program in Uganda’ The Western Journal of Medicine, 146, Part 6, pp 726-729 Reardon, T, Abdoulaye, A, Kelly, V, Delgado, C, Matlon, P, Hopkins, J and Badiane, 0 (1993) ‘Anriculture-led income diversification in the west African semi-arid tropics: Nature, distribution, and importance of production-linkage activities’ in A Atsain, S Wangwe and A G Drabek (eds.), African Economic Issues (forthcoming) Reardon, T, Delgado, C and Matlon, P (1992) ‘Determinants and effects of income diversification amongst farm households in Burkina Faso’ Journal of Development Studies Schultz, T P and Tansel, A (1993) Measurement of returns to adult health. Morbidity effects on wage rates in Cote D’lvoire and Ghana, Living Standards Measurement Survey Working Paper No. 95, World Bank, Washington, DC Traore, A (1991a) ‘The cost of AIDS: food for thought’ The Courier, No 126, pp 47-49
572
Food Policy 1994 Volume 19 Number 6
The role of labour in food security: L. R. Brown et al. Traore, A (1991b) ‘Interview with Dr. Michael Merson: We have to think of AIDS as a development problem, not just a health one’ The Courier, No 126, pp 5G52 von Braun, J, Bouis, H, Kumar, S and Pandya-Larch, R (1992) Improving food security for the poor. Concept, policy and programs, International Food Policy Research Institute Occasional Paper, Washington, DC von Braun, J, Hopkins, R, Puetz, D and Pandya-Larch, R (1993) Aid to agriculture: Reversing fhe decline, International Food Policy Research Institute Food Policy Report, Washington DC von Braun, J and Pandya-Larch, R (1991) Income sources of the malnourished people in rural areas: Microlevel information and policy implications, Working Paper No. 5 on Commercialization of Agriculture and Nutrition, International Food Policy Research Institute Food Policy Report, Washington, DC World Bank (1989) India, Poverty, Employment, and Social Services, World Bank Country Study, Washington, DC World Bank (1986) Povero and Hunger, World Bank Policy Study, Washington, DC
Food Policy 1994 Volume 19 Number 6
573