AIDS toll in African heartland isn’t always what people think

New ways to study the impact of HIV/AIDS on rural African families is showing that conventional wisdom isn’t necessarily wise, and pointing to better ways to help those struggling in the wake of death.

A new method to gauge who is most likely dying from AIDS, and what it means to rural families, is painting a new picture of HIV/AIDS in the heartland of African countries most affected by this disease.

Researchers at Michigan State University, with African counterparts, have devised new ways to understand which families’ livelihoods are most threatened after losing a family member to AIDS, and how both families and communities can be helped.

The picture emerging is less about an annihilation of families, but is a more nuanced pattern of loss that cripples some families and leaves others with a better chance of enduring.

“We want to be more effective in helping and we want less negative consequences of the assistance,” said Michael Weber, MSU professor of agricultural economics. “Policies and mitigation programs can have a negative spill over on the rest of the households in these communities. We want to avoid rearranging the chairs on the Titanic as it’s going down. You want to target those who need the help in a way that helps them and doesn’t inhibit but stimulates growth for the rest.”

The research is being presented this week at a pre-conference meeting of the 15th International AIDS Conference in Bangkok, Thailand.

The group is presenting ways to get at the elusive understanding of who is dying from HIV/AIDS-related illness in the agricultural countryside of severely affected countries of sub-Saharan Africa, where those infected are rarely tested and formally diagnosed. Weber and his colleagues at USAID and in-country governmental agencies have spent years amending surveys of rural populations in Kenya, Malawi, Mozambique, Rwanda and Zambia to include questions about which, if any, family members have died, their age, their gender, and their place in the household.

“We’re finding that counter to conventional wisdom, there aren’t as many households completely disappearing,” Weber said. “The number of orphans isn’t as large as it was thought of. This is putting a more realistic balance on magnitude of the problem.”

The research also reveals that in four of the five countries studied, a majority of the prior adult mortality was not among heads of households or spouses, but among others, usually adult children.

What’s crucial, the studies show, is not only about how many are dying of AIDS, but who is dying. The worst-case scenario is for a farming family headed by a widow.

A wife’s death is a tragedy for a family, but in Africa men have much better prospects of remarrying and recovering some of the lost labor to run the household and farm. A widow left to head a household not only faces bleak chances of remarrying, but African asset distribution often shuts women out, Weber said. In a place where possession is nine tenths of the law, unfarmed land is more likely to be lost.

A better understanding of the dynamics of family loss can both better shape aid, and begin to give insights about improved tools for prevention, Weber said. Already indications are that agricultural policies focused exclusively on reducing labor demands for crops seem misguided. The impact of AIDS, the group has shown, is not always nor necessarily in the fields.

“We feel very strongly that it would be a serious mistake to put all of the agricultural research resources into labor saving crops and technologies,” Weber said. “The most important thing from a labor-saving standpoint is not about agriculture production alone. It’s also in three critical things that women have to spend time on: carrying water, carrying firewood and preparing food. If you can reduce labor needed for these three things, that would make more sense and it would benefit all families, not just those with deaths.”

The group also found the need to focus on aid that didn’t help families suffering a “death shock” at the expense of promoting growth for all poor families in these communities.

MSU’s paper, done with assistance from USAID’s Bureau for Economic Growth, Agriculture and Trade, and the Africa Bureau, as well as with the help of many African counterparts, is to be presented today at a pre-conference session. MSU is the only institution to have two papers accepted for the pre-conference session to this major world gathering of scientists and policy makers.

Besides Weber, MSU faculty and graduate student authors from the department of agricultural economics, and economics, are David Mather, Cynthia Donovan, Thomas Jayne, Edward Mazhangara, Linda Bailey, Kyeongwon Koo, Takashi Yamano and Elliot Mghenyi. Copies of the papers being presented in Thailand and of other work in this area by the MSU group are available at: www.aec.msu.edu/agecon/fs2/papers/idwp82forreview.pdf