The impact of 30 years of HIV on an area once described as the epicentre of the African AIDS epidemic will be discussed at a lecture hosted by the University of East Anglia (UEA) in London this month.
Progressive declines in agricultural production, with dire consequences for rural livelihoods, were originally predicted as a result of the long-term effects of HIV and AIDS in central and south western Uganda. However, recent research has shown that those forecasts have not come true.
The lecture "30 years into the HIV epidemic in South West Uganda and the rural economy hasn't collapsed. What happened?" takes place on November 25 at UEA London, ahead of World AIDS Day on December 1. Prof Janet Seeley, of the university's School of International Development, will report on research carried out over the last three decades that has looked in more depth at the impact of HIV-related infection and AIDS-related deaths on individuals, communities and livelihoods, in order to contribute to the design of policies and programmes that address the ongoing issues.
Prof Seeley, who has studied the effects of HIV/AIDS on rural communities in East Africa, in particular Uganda, for more than 20 years, will explore the reasons why rural livelihoods have proved to be much more resilient than had been expected in this region, and suggest lessons for forecasting.
In the mid 1980s south-western Uganda and north-western Tanzania were often referred to as the epicentre of the African AIDS epidemic. When first identified HIV/AIDS was of concern as a possible adverse factor in social and economic development because of its specific impact in the 15-50 age group.
The research carried out by Prof Seeley and colleagues Prof Tony Barnett, of the London School of Economics and Political Science, and Prof Stefan Dercon of the University of Oxford, has found that HIV/AIDS has sometimes thrown households into disarray and poverty, but more often it has reduced development and kept households poor.
"People have undoubtedly suffered terrible personal loss and distress, but those who have survived have drawn on support from family and friends and from local organisations to rebuild livelihoods. People have shown resilience and managed," said Prof Seeley. "For some the epidemic has been devastating but often on a household level families have adapted and the community as a whole has done better than expected. While there have been so many other crises, drought and crop failure for example, there have been new opportunities as well.
"People have been changing occupations, diversifying, not necessarily because of HIV but because of diseases that have affected their crops and animals and pressures to earn a cash income. They haven't only had to face HIV/AIDS, they've had problems inflicted by drought, pests and other human disease."
However, Prof Seeley stresses that poverty remains, as does the endemic HIV disease, and that the health status of the population is poor and life remains hard.
"The effects of HIV/AIDS are not as apparent with the simple clarity once assumed because so much else is going on in any society. For policymakers this research shows that they cannot focus on one aspect and assume everything can be attributed to that - too often HIV is reduced to a medical issue, but so much of what is going on is to do with social lives and behaviour, not just sexual behaviour. Resources often go to the medical and not the social support.
"The challenge for development policy and implementation continues to be to find ways of addressing the persistent poverty and deprivation, which in part contributed to the particular manifestation of the AIDS epidemic in this region."