Global Triage - Food First or HIV First?
September 17, 2008 The global rise in food prices is triggering a crisis in many poorer countries. In many donor circles this has raised the question of whether money earmarked for HIV treatment and prevention should now be diverted to address food shortages as part of our HIV programs as Dr. Ramon Soto suggested at AIDS 2008. It's got me wondering where the boundary between HIV treatment and general health and welfare issues lies.
Should it be the responsibility of organizations working against HIV to devote their funding, which doesn’t reach far enough as it is, to try and solve other societal issues they encounter in the fight against HIV? Or should it be the responsibility of other relief organizations or the local governments themselves?
In the parts of the world suffering most from HIV, organizations are already struggling to provide universal access to ARVs, viral load and CD4 monitoring as well as prevention. The money is never enough to help everyone as it is. Spreading those funds even further to include food support could undermine the progress made thus far.
On the other hand, the food crisis is fundamentally undermining the effect of those people who do receive HIV treatment. Rising food prices are not only affecting the health of people living with HIV, it is changing the priorities and behavior of people in general. More and more individuals living with HIV are going to have to decide between buying medicine or buying food. The ones who do buy medicine at the expense of their nutrition won’t be getting the full benefit of treatment anyway since their immune systems will already be so weak.
For me, this is a real chicken and egg situation. Both sides of the argument have ugly downsides. So any solution will be the lesser of two evils I suppose. It’s determining which is the lesser that has me stumped. What do you think?
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