Already weak and unable to work or farm, Ndayizeye has often contemplated stopping the ARVs to suppress the huge appetite the medication gives her.
"I know if I stop taking the drugs I am likely to die and there will be no one left to care for my children; since my husband passed away five years ago," she told IRIN/PlusNews. "That's the reason I keep taking them, but the drugs are terrible."
Ndayizeye receives food aid from a local NGO, but uses it to feed her entire family, so the rations are far from adequate.
"When assessing the needs of people living with HIV in the country, we find that food is an enormous problem," Jean Rirangira, the interim executive secretary of the national AIDS Control Council, CNLS, told IRIN/PlusNews.
Several parts of Burundi regularly experience food shortages. According to the UN World Food Programme (WFP) (see: http://www.wfp.org/country_brief/indexcountry.asp?country=108 ), only 19 percent of the population is food-secure and as many as 46 percent are chronically malnourished.
Grinding poverty is widespread. At least half the country's 7.5 million people live on less than US$1 a day and humanitarian agencies say the global food crisis is taking a heavy toll.
"Rising food prices have increased food insecurity and made maintaining basic nutrition a challenge for thousands of people in Burundi," the UN Office for the Coordination of Humanitarian Affairs reported in August. "The current level of food production has not been high enough to augment household incomes in rural and urban areas and people continue to be unable to cope with high food prices."
For people living with HIV, the situation was made worse when in 2006, WFP cut special feeding programmes for people living with HIV (see: http://www.irinnews.org/Report.aspx?ReportId=62671). Under the new rules, HIV-positive people could only benefit from food aid if they fell into another category of people in need and could therefore benefit from programmes intended for, for instance, refugees or school children.
In 2008, following pleas from the government and NGOs, WFP reversed this decision. "WFP Burundi reviewed the profile of HIV/AIDS beneficiaries... and resumed assistance to only those under ARV treatment," WFP's Isidore Nteturuye said.
Feeding the family
However, NGOs caring for people living with HIV say the agency needs to go further still, and provide food to patients and their families.
"At our centre we try to provide support to the entire family, because the person with HIV is not the only one facing food shortages," said Jeanne Gapiya, founder of the Association nationale de soutien aux seropositifs et sideens (national association supporting HIV-positive people or those with AIDS), which cares for 3,200 families in Burundi. "If it is an HIV-positive woman, she will usually feed her children first and remain with nothing herself."
Gapiya said her organisation, the government and WFP were in discussions to try and find ways to provide more food to families affected by HIV.
Burundi's most recent proposal for US$150 million in HIV funding from the Global Fund to fight AIDS, Malaria and Tuberculosis has been accepted (see: http://www.plusnews.org/Report.aspx?ReportId=81105). CNLS's Rirangira said providing food to people living with HIV, their families and others affected by the pandemic such as orphans and vulnerable children, would be a priority.
Good nutrition helps to extend and improve the quality of life of people living with HIV and strengthens the body's ability to fight opportunistic infections.
* not her real name
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