Issue 19 Editorial

This issue of Field Exchange is dedicated to Prof. John Kevany (ENN Director) who died on 20th April 2003. John was instrumental in establishing the ENN. Given John's significant work with Ireland Aid in the area of HIV/AIDS it is fitting that this issue features prominently in this Field Exchange.

A field article by Hisham Kogali from IFRC describes the massive HIV/AIDS problem in Zimbabwe and the implementation of a home based care programme (HBC) for people living with HIV/AIDS. At the end of 2001, there were approximately 780,000 AIDS orphans in Zimbabwe while an estimated 2,300,000 people were infected by HIV/AIDS. The HBC programme, which IFRC began implementing as far back as 1988, aims to address the problem through information dissemination, improved access to care and provision of support through activities like income generation, agricultural projects and food distributions. The programme has recently been implemented against the backdrop of drought and increased food insecurity. There have been many challenges, which have in turn led to important lessons that should prove useful for other agencies working in similar contexts.

This issue also carries summaries of a number of recent publications specifically related to HIV in food crises and emergencies. Perhaps the most controversial of these is a paper written by Alex de Waal, who describes what has been occurring in southern Africa as a 'new variant famine'. De Waal argues that the HIV/AIDS pandemic in the region is leading to a new type of famine, as households suffer through the 'squeeze' on sick adults, higher dependency ratios and reduced life expectancy. Normal coping mechanisms are overwhelmed and when faced with drought and crop failure, people become locked into strategies which are less productive. De Waal predicts that this could lead to famines with levels of starvation never seen before. The implications of this are a need for massive aid and long term welfarism, and a shift away from purely child-focused interventions. While this is very much a 'think piece' with no supporting data or evidence for its main conclusions, the ideas are compelling and disturbing.

Red Cross volunteers train carers in households to look after people living with HIV/AIDS

A less controversial review, published by the Overseas Development Institute (ODI), examines how emergencies exacerbate vulnerability to HIV. The review contains a number of recommendations in areas of policy making, risk assessment, programming decisions with regard to vulnerability to sexual violence and exploitation, and provision of health care. Implications for staff training are emphasised. A central theme running through the review is that HIV is a cross cutting issue and HIV activities need to be integrated into existing programme channels, rather than addressing the problem in stand alone, isolated HIV programmes.

A move towards such integrated programming is reflected in a WFP policy document on HIV highlighted in the news section. Recently endorsed by WFP's Executive Board, critical recommendations include i) WFP will incorporate HIV/AIDS concerns into all programming categories and ii) when HIV/AIDS threatens food security and influences mortality in ways similar to other disasters, WFP will consider HIV/AIDS as a basis for a protracted relief and recovery operation (PRRO). Also in news, FAO/WHO have recently published a manual on nutritional care and support for people living with HIV/AIDS . It contains practical recommendations for a healthy, well balanced diet in countries or areas with low resource bases, and aims at improving nutrition in home based settings.

A second theme running through this issue of Field Exchange relates to assessment methodologies for identifying and justifying appropriate non-food aid interventions in food crises. Two experiences are described in this issue. The article by Dereje Tieke describes CARE's livestock destocking programme in Ethiopia following a protracted drought. The programme appears to have been highly successful in that it reduced livestock asset loss, led to sustainable meat processing and reduced pressure on rangeland. Many lessons were learnt during the programme, including the unanticipated ability of local systems to 'bounce back' and return to livestock holding rather than sale, once the situation improved. Valuable lessons are also highlighted in the summary of a published paper about a seed multiplication project in southern Sudan. As the project evolved, lessons emerged over the inappropriateness of the selected seed varieties, and it became clear that implementing agencies had not drawn sufficiently on local information during project planning. Both experiences demonstrated how much more there is to learn about the implementation of such projects.

It may, in part, be this steep learning curve which creates a tendency to opt for more tried and tested interventions based on food aid provision. A recent Groupe Urgence Rèhabilitation Dèvelopment (URD) evaluation in Afghanistan (page 17), criticised the use of 'blue print' food aid programmes, like supplementary and therapeutic feeding. Factors contributing to this type of 'unimaginative' programming were identified as urgency to respond, donor pressure to yield results, competition between agencies for funds and visibility, and lack of staff with nutritional experience and knowledge of Afghanistan. Similarly, a recent review of livelihood assessments in situations of chronic conflict and political instability (SCCIPI) (page10 ) found that assessments were mainly used to identify the need for food aid. The reviewers suggest that this may be due to limited scope for supporting livelihood strategies in SCCIPI, fear of fuelling conflict, funding constraints (programmes fall between relief and development) or agency mandate (most agencies focus on a limited number of specific interventions). The authors conclude that, even in SCCIPI, there is often much scope for livelihoods programming and that this should be addressed by needs assessments.

This conclusion was reinforced at a recent WFP technical meeting on emergency needs assessment (page27 ). A number of donors present at the meeting expressed concern that agencies conducting assessments often overestimate food aid needs, citing southern Africa as an example, while the potential for non food aid interventions is not adequately examined or justified in assessments and resulting proposals. At the same time, donors admitted that their confidence in assessment findings depended, to some degree, on the reputation of agencies and demonstrated use of a recognised methodology.

The tendency amongst some agencies to rely too much on standard food aid responses in emergencies may be underpinned by assessment methodologies which have not been developed adequately to identify the need for, and appropriateness of, other types of intervention, e.g. market support, livestock off-take, agricultural support, etc. This is worrying as in some situations, non-food aid responses to food crises are probably more appropriate in terms of timing, cost-effectiveness and longer term impact. This is a bit of a 'chicken and egg' scenario as strengthening emergency needs assessment methodologies in terms of identifying scope for nonfood aid interventions is to a certain extent dependent on experience of implementing these types of programmes. Perhaps what is needed at this stage is more of a commitment to engage in the process of strengthening ENA methodologies. The one area where assessment methodologies for non-food aid interventions appear to be developing are 'seeds and tools provision'. A recent review , summarised in this issue, concluded that many seeds and tools programmes are automatic 'knee jerk' responses to the post-emergency phase, yet such programmes are often unnecessary. The authors propose a methodology called 'seed profiling', which should help determine whether such programmes are necessary and workable. It is precisely this type of analysis and methodological development that is urgently required for the many other types of non-food aid interventions which are periodically piloted, but rarely implemented, on any scale in food emergencies.

Jeremy Shoham