By Francis Okoye
Dr. K .S Sachdeva, Deputy Director General, National AIDS Control programme, ministry of health and family health, India was guest speaker at the SDM Health Justice lecture series webinar held on June 30th, 2017 on the topic “Food Security for people with TB and/or HIV?
Speaking about the India scenario, he said that about 1/5 adults in India are malnourished and this is higher in 15-19 age groups, in women and in lower income people. TB in India records 27% of global burden, being the highest TB burden and India has 3rd highest HIV burden. He was speaking using India as an example.
MAKING NURITION AN ITERGRAL PART OF HIV/AIDS RESPONSE
Lack of nutrition in PLHIV results in additional problems for them, ranging from malabsorption, diarrhea, altered metabolism to increased HIV replication, Hasten disease progression and increased morbidity. It also leads to increased oxidiative stress and immune suppression, not to talk of effects of nutritional deficiencies.
According to Dr. K S Sachdeva, adequate nutrition cannot cure HIV infection but essential to maintain immune system and sustain physical activity. Nutritional education must be institutionalized, improved access to nutritional control, scale up community based nutritional interaction and expand the scope of reproductive and sex health.
UNDER NUTRITION AND RISK OF TB Since under nutrition is highest among women, villagers, younger age group and lower quintiles of wealth index, the outcomes are alarming, as the risk of relapse is 4 times compared to those of normal nutrition. 1/3 men and ¼ women had normal BMI after successful treatment. Nutritional support to TB patients resulted in better outcomes.
BATTLING FOOD SECURITY FOR HIV OR TB The three key ways to do this is through nutritional assessment, nutritional counseling and nutritional management
.NUTRITIONAL ASSESSMENT Involves clinical assessment, anthosprometric measurement and class of nutritional status.
NURITIONAL CONSELLING Concept of healthy balanced diet, understanding foods and practices to avoid ,use of locally available nutrient rich food
Recommended energy, protein and micronutrient intake ,management of moderate to severe under nutrition in patient with enhanced family PDS ration.
Countries should emulate India whose guidelines for providing nutritional care and support for adults living with HIV & AIDS in India is based on WHO report of a Technical Consultation, and SDG2: Zero hunger .India had 1,64,435 patients linked to existing nutritional schemes as at December 2016, while 1,90,022 indirectly benefited through livelihood schemes. Other countries like Nigeria should have introduced nutritional schemes and livelihood schemes like India for HIV and TB patients, as we can see that improved nutrition helps greatly in the fight against TB and HIV-this is the only way we can have food security work for us.