Livestock is often sold to pay funeral expenses, and orphaned children often lack the skills to farm or look after livestock in their care. The epidemic has been understood as not just a health issue, but as a major threat to development and to human security. To the familiar examples of Uganda, Senegal and Thailand we can now add parts of Zambia and Mbeya in Tanzania, and in Brazil there has been national success in curbing the epidemic. Most important, we need to apply proven strategies on a scale commensurate with the epidemic. The time for pilot or demonstration projects is over, now is the time to mainstream and decentralise.
Success comes from long-term sustained commitment.
Piecemeal approaches don't work. This is a message that I know you are familiar with, because it is fundamental to nutrition practice. The nutrition community knows the global and the local are connected, that individual care comprises many inter-related elements, and that health always goes beyond the individual to involve the household and community. But despite what we know about how to turn back the epidemic, we are still a long way from achieving success. Let me propose seven key challenges ahead.