admin | February 20, 2023
News Brief
Mary Phiri walks frailly, occasionally wiping the morning dew from her arms as she searches for food in her maize field. After a long search, she finds some not-so-healthy pumpkins and ears of maize. This will be her only meal of the day before Mrs. Phiri, a widow who has been living with HIV since 2014, can take her antiretroviral drugs. Economic hardship caused by the COVID-19 pandemic, combined with poor food harvests due to erratic rainfall and armyworm outbreaks, means many Zambians living with HIV no longer have adequate nutrition. This has made taking their antiretroviral medicine more painful and left them vulnerable to opportunistic infections. Antiretroviral drugs don’t have to be taken with food, but the medicine can leave some patients hungrier and wanting to eat more often. Numerous studies also have shown that lack of a nutritional diet can reduce adherence to antiretroviral drug therapies.
Mary Phiri walks frailly, occasionally wiping the morning dew from her arms as she searches for food in her maize field. She stops to inspect stalks of maize on her small farm in Rufunsa, a rural district about 160 kilometres east of the capital, Lusaka.
Disappointed, she says, “The crops have failed us.”
Some of her stalks of maize are withering because of drought, and those that aren’t have been infested by armyworms. After a long search, she finds some not-so-healthy pumpkins and ears of maize. She wraps them in her chitenge, a colorful cloth that Zambian women often wear around their waists, and slowly walks back to her house, a small mud hut with a grass-thatched roof. She lies down on a reed mat to rest and asks her 16-year-old daughter to start a fire outside the hut. This will be their only meal of the day before Mrs. Phiri, a widow who has been living with HIV since 2014, can take her antiretroviral drugs.
Economic hardship caused by the COVID-19 pandemic, combined with poor food harvests due to erratic rainfall and armyworm outbreaks, means many Zambians living with HIV no longer have adequate nutrition. This has made taking their antiretroviral medicine more painful and left them vulnerable to opportunistic infections.
Felix Mwanza is the director at Treatment Advocacy and Literacy Campaign, a civil society organization that advocates for people living with HIV and AIDS. He says that, although Zambians living with HIV get free antiretroviral drugs from government health centres, proper food intake has remained a challenge for many. He says many people have stopped taking antiretroviral drugs because of lack of food. He adds, “They fear the adverse effects that the drugs may have on their bodies once taken without food.”
Antiretroviral drugs don’t have to be taken with food, but the medicine can leave some patients hungrier and wanting to eat more often, says Corrine Zulu, a pharmacist based in Lusaka. Numerous studies also have shown that lack of a nutritional diet can reduce adherence to antiretroviral drug therapies.
It could get worse. Climate change and inconsistent weather in Zambia continue to cause extreme events like floods and drought, which have led to crop failures.
Nutritionist Tsitsi Kapandamake says lack of adequate food makes people living with HIV prone to complications. That’s because taking drugs on poor nutrition can exacerbate side effects and make a person more susceptible to other infections, further damaging the body. She says, “It is advised that people living with compromised immune systems have a diverse diet and eat sufficient amounts of food frequently to help them fight infections.”
Zambia has one of the highest rates of HIV infection in Africa, with about 1.5 million people living with the virus. In 2020, the country recorded an estimated 69,000 new HIV infections, according to the UNAIDS. Zambia adopted the World Health Organization guidelines that recommend treatment for anyone who tests positive for HIV, regardless of whether they show symptoms of illness. Just over 80% of Zambians living with HIV are on antiretroviral drugs.
Chrispin Makungu, a secondhand clothes trader in Lusaka, says two years ago he lost his 39-year-old sister, who quit taking antiretroviral drugs because they were causing adverse side effects due to lack of food.
He says: “She was struggling financially and could not afford proper meals. The drugs made her really sick. She stopped taking them and got better, but later got even sicker and died.”
Doreen Mwamba, Minister of Community Development and Social Services, says the government is trying to identify families that can’t afford food and help them with cash allowances. She says, “We are working hard to ensure every Zambian manages to eat properly.”
Since 2003, Zambia has run a program known as Social Cash Transfer to help families that can’t afford food. As of early 2022, the program had reached more than 970,000 households, with a goal to reach more than one million by the end of the year, according to an analysis by the ministry. Every two months, beneficiaries receive 400 Zambian kwacha (about US $.02), enough to buy about 25 kilograms of maize flour. The money is distributed as cash, or sent to mobile wallets or bank accounts.
However, Mrs. Phiri says she didn’t know about this government program, and so she hasn’t been benefiting.
She says she was a beneficiary of the Farmer Input Support Programme, a Ministry of Agriculture initiative that gives free fertilizer and seeds to farmers, but the lack of rainfall and the infestation of Fall armyworms have led to a dismal harvest. She has thought about moving to Lusaka, where her family lived until 2017 when her husband died of AIDS, to try to find work. But her sickness has left her without energy. Mrs. Phiri says, “When I feel hungry but there is nothing to eat, I get really weak.” She fears what may happen if the situation doesn’t improve.
This story was adapted from an article written by Prudence Phiri for Global Press Journal, titled “Medicine helps their HIV. Hunger makes it hard to take.” To read the full story and a series on HIV treatment, go to: https://globalpressjournal.com/africa/zambia/antiretrovirals-help-manage-hiv-hunger-makes-hard-take/
Photo: Mary Phiri prepares a maize porridge, known locally as nshima, at her home in Rufunsa, Zambia. It is her only meal of the day before she takes her antiretroviral medication for HIV. Credit: Prudence Phiri for Global Press Journal.