"We are all working with sustainability in mind, and we cannot always continue to rely on external support," said Dr Joseph Aimé Bidiga, who runs the health division at the national AIDS control council, CNLS. "We must take action to allow us to do as much as possible with our modest means."
According to new regulations issued by the CNLS, only people starting on life-prolonging antiretroviral (ARV) medication will be entitled to food rations, and then only for the first six months of treatment. Previously, all people living with HIV and their families were eligible for food aid.
CNLS has published a nutrition guide to help people living with HIV to identify nutritious local foodstuffs: guavas, cassava and cashew apples are identified as being rich in vitamins; other foods like baobab leaves, dried okra and fish are rich in iron. Besides using local produce, organisations are searching for innovative ways to provide food to vulnerable communities affected by HIV.
REGIPIV (Réseau pour une grande implication des personnes infectées par le VIH), a local NGO, is advocating the provision of fertiliser to people living with HIV so they can grow their own food; other NGOs are encouraging the use of direct cash transfers to people living with HIV to enable them to vary their diet according to individual need.
PAMAC (Programme d'appui au monde associatif et communautaire), a technical and financial assistance programme for organisations in the fight against AIDS, plans to give loans of between 500,000 and 1.5 million CFA francs (US$1,115 to $3,345) to people living with HIV to start income-generating activities that will allow them to have a varied diet.
In February Burkina Faso was rocked food riots after the prices of basic foodstuffs and other everyday commodities rose by between 10 and 65 percent in just a few months.
More targeted food aid
The CNLS food cuts were made after a study revealed that the food distribution structure meant resources were not managed properly. "There has been lots of bad management in the past," said Adama Konaté, from the ministerial committee for social action and solidarity, which coordinates the nutrition of people living with HIV. "We want to standardise these operations ... by giving priority to those who are in need from now on."
As a result of the cuts, several organisations have been forced to reduce the number of people they support with food aid; PAMAC is now providing food rations to one-third of its 25,000 beneficiaries, while REVS+, an association of HIV positive people with around 2,000 beneficiaries, will now give food aid to just 700 patients.
NGOs have expressed concern that the cuts in food aid could lead patients to abandon their ARV regimens, as a healthy diet is crucial to successful HIV treatment. "You have to [eat properly] to follow it; people who don't eat cannot take their [ARVs]," said Martine Somda of REVS+.
However, Konaté told IRIN/PlusNews that the new regulations were flexible, and people who depended on the food as a "means of survival" would continue receiving food aid.
Under the new CNLS criteria, patients have to complete a social survey to assess their financial vulnerability and only the poorest qualify for food rations. The health of patients, and in particular their weight, is also taken into account.
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