Nutritional experts are warning food insecurity in Africa is ripping families apart, destroying the basic fabric of the society and helping the spread of HIV/AIDS.
Researchers have long known that people suffering from HIV/AIDS are caught in the vicious circle of being too weak to work for food and consequently too malnourished to resist diseases.
But now, they say people and communities where there is not enough food are at a greater risk of exposing themselves to the virus that causes AIDS and spread it to others.
A senior research fellow at the Washington-based International Food Policy Research Institute, Stuart Gillespie explains.
"Just by being poor and being extremely food insecure, there is a higher likelihood that a family will split up, somebody will have to migrate to find work," he explained. "Wherever families are splitting up or being displaced, risk is increased, both for the person who is leaving the house and the person who remains."
He says when husbands leave home in search of livelihood, women are left to fend for themselves, and in extreme cases, are forced into prostitution in order to feed their children. That puts them at a much higher risk of getting infected with HIV.
A chairman with the Consultative Group on International Agricultural Research, Per Pinstrup-Andersen, says getting infected with HIV is the beginning of the sufferer's problems.
"Food insecure people have less resistance to any kind of disease, including HIV/AIDS, and that means that when they are affected the impact is much more severe," he said.
For instance, he says, in people who lack Vitamin A, there is a greater likelihood that HIV will transmit into AIDS.
A person infected with HIV/AIDS has much more food energy requirements. Mr. Gillespie says HIV positive people who do not show symptoms of the virus need 10 percent more proteins, micronutrients, and other energy requirements to cope with the virus.
For those who have tuberculosis, diarrhea, and other opportunistic infections, says Mr. Gillespie, they need 30 percent more energy from food.
Yet, he says, malnourished people are unable to hang onto the little energy they have.
"These people who are malnourished already, they are having to expend more energy in their daily work, more energy expenditure, far less access to health care, and virtually no access to drugs."
Mr. Gillespie says, as malnourished people get sicker, they tend to eat less and become anorexic and apathetic. When they do eat, nutrients are broken down and excreted much more quickly than in people who have adequate nutrition.
Then there is the issue of medication. Mr. Gillespie says many AIDS drugs must be taken with nutritious food to have maximum effect and to avoid serious side effects from the medication.
He says many people who have little or no nutritious food stop taking their medication because the side effects are so severe.
The director of the Health Economics and HIV/AIDS Research Division at the University of KwaZulu-Natal in South Africa, Alan Whiteside, says many HIV positive Africans cannot count on a regular and high-quality food supply like their counterparts in the United States and other western countries.
"If you look at people in the west, they have not only as much food as they need, but they also have a range of foods, and if you look at people in Africa particularly, in many instances the availability of food is seasonal," he said. "So you may have enough food at some times, but not at other times, and secondly the range of foods you have is not there."
Mr. Whiteside says, to reduce HIV exposure and lessen the impacts of AIDS on food insecure people, African policy makers need to provide vulnerable farmers with seeds, chemicals and fertilizers, and take other steps to increase food supply and access to nutritional foods.
He recommends governments also tackle the AIDS epidemic by carrying out public information campaigns on how to prevent HIV infection, and improve the treatment and care of people suffering with AIDS.
Mr. Gillespie urges agricultural policy makers to adopt what he calls the HIV/AIDS lens. He says this lens examines how their policies, programs, and decisions might increase or decrease the risk of people contracting HIV or suffering severe side-effects of the AIDS disease.