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AIDS seen spur to Africa famine
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Farmers are left too weak to plant

WASHINGTON - AIDS has contributed heavily to the growing famine across southern Africa, from killing vast numbers of agricultural workers to leaving countless sick farmers too weak to plant crops, according to a UN team that recently toured the region.

While a number of factors have contributed to the crisis, in which an estimated 14.4 million people are in urgent need of food, the role of AIDS could foreshadow the disease's destructive swath through African society: limiting longterm food stocks and exacting tolls on militaries, police forces, teachers, health workers, and others, UN officials and AIDS specialists said in interviews.

HIV, the virus that causes AIDS, infects more than 20 percent of adults in six southern African countries, targeting those between the ages of 15 and 49. Now, many places are seeing vast numbers of one generation dying while a second generation fills up with orphans unable to feed and care for themselves.

''The relationship between the HIV/AIDS pandemic and the reduced capacity of people and governments of southern Africa to cope with the current [food] crisis is striking,'' said a report of the six-nation trip written by James T. Morris, special envoy of UN Secretary General Kofi Annan for Humanitarian Needs in Southern Africa. ''HIV/AIDS is causing agricultural productivity to decline, forcing children to drop out of school, and placing an extraordinary burden on families and health systems.''

The Sept. 24 report, obtained by the Globe, said donors and governments in the region may not fully understand the link between AIDS and famine. Morris also wrote that the disease was likely to further weaken societies in multiple ways.

''HIV/AIDS is a fundamental, underlying cause of vulnerability in the region, and represents the single largest threat to its people and societies,'' he wrote.

Stephen H. Lewis, UN special envoy on HIV/AIDS in Africa, said that when he saw Morris return from his Sept. 3-15 trip in Africa, ''he was a man physically and emotionally reeling from what he'd seen. He had instantly recognized that food was only part of the problem. The heart of the problem was AIDS.''

Lewis, speaking at an AIDS conference at the Center for Strategic and International Studies in Washington on Friday, said that Morris's report should ''ring as one of the most piercing alarm bells that we've yet heard during the course of the pandemic.''

''I think it is reasonable to argue that AIDS has caused the famine, that what we all feared one day would happen is happening,'' he said. ''So many people, particularly women, have died, or are desperately ill, or whose immune systems are like shrinking parchment, that there simply aren't enough farmers left to plant the seeds, till the soil, harvest the crops, provide the food. We may be witness to one of those appalling, traumatic societal upheavals where the world shifts on its axis.''

The most immediate causes of the famine, according to those who have studied it, include prolonged drought, floods that destroyed crops, corrupt government policies, and mismanagement of food supplies.

Compounding the problem has been a controversy over the safety of the US food aid, which contains genetically modified grain. Zambia has refused to accept it; Zimbabwe and Mozambique agreed to take it after long debates that delayed the deliveries.

Morris could not be reached for comment. Another member of the delegation, Judith Lewis, director of southern Africa for the World Food Program, said in a telephone interview from South Africa that the team was amazed by the multifaceted impact of AIDS on communities.

''We saw one project, where they had pumps for water - it was like a Stairmaster at the gym,'' she said. ''You do that exercise to draw the water from the ground. But some communities can't use it because they are in such a weakened state. One of the things we need to look at is the future for agriculture-based economies and talk about long-term food security.''

Judith Lewis, who is no relation to Stephen Lewis, said the team saw the impact of the disease on ''the finances of the families, the funeral costs, the grandmothers. We saw so many grandmothers particularly left with their offsprings' children. They were not able to try to produce food.''

UNAIDS estimates that there are 4.2 million orphans in the countries facing the worst food shortages: Zambia, Zimbabwe, Malawi, Mozambique, Lesotho, and Swaziland. In sub-Saharan Africa, nearly 30 million people are infected by HIV; that equals three-fourths of cases worldwide.

Sophia Mukasa Monico, a longtime AIDS activist in Uganda and now senior AIDS program officer at the Global Health Council in Washington, said that AIDS has been hurting food production in sub-Saharan Africa for years. ''Most of the problem goes back to the fact that most people are very sick and cannot cultivate their lands,'' she said. ''In the end, you find vast pieces of land not cultivated.''

In one study of the Tororo region in Uganda, researchers found that many people with AIDS and other diseases raised crops to sell at the market, but kept very little food for themselves. Some farmers, Mukasa Monico said, were starving.

''You had people dying of hunger, but they had food to sell. That really amazed me,'' she said. ''They ate the minimum possible because they needed money to buy the drugs. They needed money to send kids to school. After they looked after school and themselves with the drugs, whatever remained they used for food.''

Stephen Lewis said the impact of AIDS on the famine should be a warning to all countries and donors, as well as those suffering the brunt of the disease.

''We've been predicting that you can't ravage the 15-to-49-year-old productive age group forever, without reaping the whirlwind,'' he said. ''There is no time left to contemplate. There is only time left to act. Southern Africa is the canary in the pandemic.''

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John Donnelly can be reached at mailto:%20donnelly@globe.com.