A Hungrier World
A Potential Solution for COVID-Damaged Food Security for People Living with HIV
by Jeannie Wraight

Throughout 2020 and the beginning of 2021, the COVID-19 pandemic shook the world to its core affecting everything from public health, economics, healthcare systems, and food and service delivery. As countries across the globe begin to eliminate COVID-19 restrictions and return to some sense of normalcy, as a global community, we must now aid in helping to pick up the pieces left in the wake of the COVID-19 pandemic. Perhaps one of the most pressing issues since the advent of the global COVID pandemic is the worsening of famine conditions in many countries, with people living with HIV being hit particularly hard.

COVID-19 has deepened the already devastating issue of food insecurity in the developing world. The World Bank estimates that 115 million people were pushed into extreme poverty by the pandemic. Over 690 million people are currently estimated to be food insecure and 190 million are reported to be living with extreme hunger. That latter number is expected to grow to 270 million by the end of 2021.

“COVID has made the world’s poorest poorer and the hungriest hungrier,” says Steve Taravella, spokesperson for the World Food Program, the UN’s hunger relief arm. Taravella says “the Rome-based agency expects to feed up to 129 million people around the world this year, the greatest number in its sixty-year history—and that the impact of the COVID pandemic is a major reason.”

Countries currently experiencing famine conditions or on the brink of famine include Yemen, Democratic Republic of Congo (DRC), Afghanistan, Venezuela, the West African Sahel, Ethiopia, South Sudan, Syria, and Haiti. High rates of COVID infections in some middle-income countries such as India, South Africa, and Brazil, have also created rapidly rising levels of hunger.

War, climate change, and poverty are typically among the predominant agents of famine. The emergence of a fourth agent during 2020—the COVID-19 pandemic—has greatly increased the number of those suffering from hunger. Disparate pandemic restrictions dramatically impacted supply chains. Business closures resulting in short-term and permanent loss of employment, school closures preventing some parents from working and children from accessing school meals, along with homelessness and the loss of family breadwinners have all contributed to the growing rate of hunger—and in many cases in unforeseen communities. Globally, local farmers and processors—universally the main source of food for non-urban areas—were unable to adequately manage their land and workers, and their supply chains further contributed to food shortages.

For people living with HIV in the developing world, the effects of the COVID-19 pandemic greatly worsened complex socioeconomic conditions and access to food, medical care and HIV services. Resources once directed for HIV have been diverted during the COVID-19 pandemic, including the attention of public health leadership, medical personal and facilities, and financial and research budgets.

Mathematical models show that severe treatment disruptions in high HIV-burden areas could increase HIV-related deaths by 10% over five years, and HIV treatment interruptions in sub-Saharan Africa of 50% of patients for six months could lead to more than 296,000 HIV deaths within a year. Due to innovative strategies, treatment interruptions in many countries were not as severe as feared, yet the consequences people living with HIV are experiencing, and will experience for years to come, are significant.

One of the most effective tools we have in combatting famine are ready-to-use-therapeutic foods or RUTFs. RUTFs are pre-packaged high-caloric therapeutic foods that contain dense levels of vitamins and nutrients aimed to treat malnutrition in both children and adults.

Malnutrition in adults living with HIV can have devastating effects on the immune system, weakening the body’s response to HIV and other infections, including COVID-19 (which significantly heightens mortality in this population). Severe weight loss is one of the strongest factors associated with serious illness and reduced survival in people living with HIV, even those on antiretroviral therapy. Research indicated that macronutrient supplementation such as that provided in RUTFs has a positive effect on weight gain and adherence to medication in people living with HIV.

For children, even short-term malnutrition can result in lifelong complications. Malnutrition in children is known to cause weaker immune systems as well as lower intelligence and diminished socioeconomic skills. The WHO estimates that due to the COVID-19 pandemic, interruptions in mother-to-child viral transmission services could increase child deaths from HIV by 40-80% in areas with high rates of HIV infection.

The totality of these impacts on adults and children living in high HIV burden areas can be reduced if proper nutrition is supplied in right measure. At minimum, the supply of RUTFs for HIV-positive children is essential.
During a time when as Americans we are struggling to overcome the setbacks of the past year, we must not relent on the fight against HIV in the developing world. Funding and resources in these regions have taken a devastating hit as countries around the globe strive to recover from the havoc caused by the COVID-19 pandemic.

According to Mark Lowcock, United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, in the absence of humanitarian assistance the lives of 235 million people are at stake during 2021 alone. Ensuring access to RUTFs for people living with HIV can help save the lives of millions of people currently struggling to survive not just one but two pandemics.

Jeannie Wraight is the former editor-in-chief and co-founder of HIV and HCV Haven (www.hivhaven.com) and a blogger and writer for TheBody.com. She is a member of the Board of Directors of Health People, a community-based organization in the South Bronx and an advisor to TRW (Teach me to Read and Write), a community-based organization in Kampala, Uganda. She lives with her husband in New York City.