Treating HIV/AIDS Patients in Swaziland

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By Katherine Reed Finberg

The nurse at Good Shepard Hospital in Siteki, Swaziland is adamant when asked if food and nutrition play an important role in the antiretroviral therapy (ART) program she manages. “Food and antiretrovirals are 50/50 components for treating HIV, you can’t divorce them. A person can’t take medicine on an empty stomach. Food comes first and then they take the drugs.”

More than 2,200 people, half between the ages of 15 and 24 years old, are enrolled in the Good Shepard Program, one of a handful of ART programs in Swaziland. Most of the clients who receive treatment for HIV also receive food rations in an effort to boost their weakened nutritional status, which in turn enables them to fight off infections and allows the drugs to work at maximum effect.

The roster is crowded and the hours are long, but when you ask Steven Lukele, the Storeroom Manager, if he's tired, he'll just shrug and continue talking about how dramatic the difference is between the first time he meets a person and the second time. Steven manages the food distribution for the ART program at Good Shepard Hospital, where the World Food Program (WFP) provides corn-soya blend, a highly nutritious blended food, and a family ration of cooking oil, pulses and maize meal for food insecure people on ART.

Steven deals with people living with HIV—and sadly, dying of AIDS—every day of every week, month after month. It is surely difficult, but he prefers to dwell on the positive; and there is quite a dose of that in any ART program, especially those with integrated food components. Steven says that most of the people he sees are able to return to productive activities just two to three months after beginning the powerful combination of drugs and food.

It is hard to imagine what the future holds for the people of Swaziland. More than 40 percent of the adult population is HIV positive in this country of 1.1 million people. The swelling number of orphans has exceeded crisis proportions and many children get left behind more than once, as they first suffer the death of their parents, then of their secondary caregivers. 

It doesn't demand great imagination to recognize the numerous benefits of linking good nutrition and treatment. The longer parents stay alive and healthy the better chances their children will be well nourished, well educated and have healthier families of their own someday. Added benefits include helping to stabilize families and communities, since it is often the loss of the breadwinner that results in the breakup of the household.

Gavin, who is living with HIV and has experienced the withering social stigma associated with the disease, firmly believes that food rations can improve the quality of life tremendously. He says that it is the food, in fact, that can help break down the stigma and silence around AIDS. "Food can help people living with AIDS to see that it's not the end of the world. They can get out of bed and be a person again." And the same sentiment is echoed in Mozambique. One man, who receives WFP food through a home-based care program, says that the food package is not only essential for getting better, but it prevents him from becoming a burden on his family and allows him to continue to be a good father, contributing to the care and well-being of his children.

Of course food alone is not adequate in the struggle against HIV/AIDS.

It takes food and the drug therapy together to allow people with this disease to survive and even thrive. But the time is past due to recognize that food is an essential care and treatment package for people living with HIV/AIDS. The next generation depends on it.

Katherine Reed Finberg is a public health consultant who has lived and worked in Africa for various organizations, including the World Food Program, where she specialized in HIV/AIDS and Food for Education issues.

This piece was originally published in Bread for the World Institute's 2006 Hunger Report, Frontline Issues in Nutrition Assistance. Find out more about the publication or order your copy from our online store.