Beginning in 2001, smallholder peasant households in Malawi faced two life-threatening risks: AIDS
and famine. Malawi registers the 8th highest HIV/AIDS prevalence in the world (UNAIDS 2004) and
is one of the continent’s least urbanized countries with 85 per cent of the national population living in
rural areas. Much of the countryside has a reputation for being ‘deep rural’ in the sense that it is
characterized by a patchy road network and poor physical, economic and social infrastructure within a
culturally conservative context of village-based traditional tribal leadership. Between 2001 and 2003
the countryside experienced widespread hunger. Speculation about possible links between HIV/AIDS
and famine inevitably ensued.
De Waal and Whiteside (2003) argues that a ‘new variant famine’ surfaced in the context of a
rural population predisposed to food insecurity by the prevalence of AIDS morbidity and mortality. It
would be impossible to conclusively prove or disprove this thesis. Certainly, the deteriorating welfare
status of the Malawian rural population amidst the rising prevalence of HIV/AIDS prior to the famine
can be amply demonstrated (e.g. Ngwira, Bota and Loevinsohn 2001, Frankenberger, Luther, Fox and
Mazzeo 2003). This paper explores the interacting effects of HIV/AIDS and famine. Based on key
informant interviews, focus group discussions and a random survey of 141 households in three
villages as part of a CARE International study carried out in Lilongwe rural district, Central Province
between December 2003 and March 2004. Villagers’ coping strategies and social responses under the
combined duress of HIV/AIDS and famine are highlighted.