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Thirty-Second Session of the Standing Committee on Nutrition

SCN Working Group on Nutrition and HIV/AIDS Contribution to Millennium Development Goals

held during the SCN's 32ND Session, 15 March 2005, Brasilia

Chair: Andrew Tomkins (Institute for Child Health, UK)
Rapporteur: Bruce Cogill (FANTA)

The Working group, chaired by Andrew Tomkins, heard from four presenters. The topics covered various nutrition and HIV/AIDS interventions from experiences in Brazil where a comprehensive HIV/AIDS program reaches HIV infected individuals throughout the country and presented by Dr. Silviera from the Ministry of Health. Significantly, the Brasilian program provides support for the purchase of infant formula for children of HIV infected mothers. Testing is widespread and widely accepted.

Dr. Tomkins gave an overview of some of the recent findings around nutrients and HIV outcomes including data that suggested that nutritional risk exists in non-infected children of HIV infected mothers. He highlighted recent findings of the positive effects of some micronutrient and multimicronutrient interventions with respect to disease progression, pregnancy outcomes, and possible survival. While more work needs to be done to pinpoint formulations, target groups, protocols and other aspects, the exciting prospect of a role for food and nutrients in improving nutritional and disease outcomes has arrived. The challenges represented by the expansion of ARVs includes the many unkowns of the effects on the metabolism of lipids and other nutrients already seen in chronic ARV users. While the situation in resource limited settings of these effects remain unknown, we are reminded that the reach of ARVs remains limited and the eligibility criteria strict. The nutritional aspects are even more critical of those HIV infected but largely asymptomatic adults and children.

IPFRI provided a review of the food security and livelihood aspects of the disease including the implications for policy and programs. Concepts drawn from the field were presented to aid in the understanding of the multiple implications of HIV;AIDs and the possible responses.

Dr. Cogill from USAIDs FANTA Project presented the food and nutrition responses to HIV/AIDS in Africa with special emphasis on the support provided to implementers through the US President Emergency Response to HIV:AIDS relief (PEPFAR). He highlights the challenges represented by a program that is focused on treatment, prevention and care and support. PEPFAR does not provide food for general feeding or income transfer but will support counseling and behavior change as well as therapeutic foods the rehabilitation of severely malnourished adults and children. Other resource streams provide food for income transfer and incentives for participation in ARV programs etc. These include food aid from the WFP, US Title II food and other sources including community resources. Challenges were heard from the audience on the lack of capacity in the countries to scale up the large scale programs and for sustainability.

The meeting heard about two important meetings happening the week of April 10 in Durban South Africa. WHO in collaboration with the NIH in the US and other groups is hosting a meeting on nutrition and HIV AIDS which will present current evidence for the nutritional requirements for the HIV infected. The meeting will be an opportunity to broaden the consultation process that WHO has been supporting which has comprehensively reviewed the evidence of energy, protein, lipid, and micronutrient requirements for asymptomatic and symptomatic individuals. The meeting will hear from colleagues in the region who have developed their own guidelines and the challenges they have faced in affecting policy and operations at all levels in their countries.

Following the WHO meeting in Duban, IFPRI will host an international meeting on HIV/AIDS and food and nutrition security. Building on the RENEWAL project network, IFPRI and invited speakers will review current evidence on the relationships and enhance learning among African institutions and other regions especially among sectors, develop tools and mechanisms for a more effective response. A joint statement is expected from the meeting with WHO on next steps.

The SCN has an important role for the appropriate interdisciplinary response to the epidemic. Despite resource restrictions and limitations, HIVAIDS represents an unprecedented opportunity to bring the best evidence for food and nutrition to what is the largest public health program in history.

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