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HIV/AIDS, climate change and disaster management: challenges for institutions in Malawi
May 2008
Pablo Suarez, Precious Givah, Kelvin Storey, Alexander Lotsch
The World Bank

Acknowledgements: FANRPAN acknowledges The World Bank as the source of this report:


Southern African institutions involved in disaster management face two major new threats: the HIV/AIDS pandemic (eroding organizational capacity and increasing vulnerability of the population), and climate change (higher risk of extreme events and disasters). Analyzing the combined effects of these two threats on six disaster-related institutions in Malawi, the authors find evidence of a growing gap between demand for their services and capacity to satisfy that demand. HIV/AIDS leads to staff attrition, high vacancy rates, absenteeism, increased workload and other negative effects enhanced by human resources policies and financial limitations. Many necessary tasks cannot be carried out adequately with constraints such as the 42 percent vacancy rate in the Department of Poverty and Disaster Management Affairs, or the reduction of rainfall stations operated by the Meteorological Service from over 800 in 1988 to just 135 in 2006. The authors highlight implications of declining organizational capacity for climate change adaptation, and formulate recommendations.


Institutions dealing with disaster preparedness and response in Southern Africa are facing two enormous challenges: Climate change (IPCC 2007), and HIV/AIDS (UNAIDS 2006). A changing climate is expected to increase the risk of disasters (van Aalst 2006) and consequently the demand for services that those institutions provide. Yet the HIV/AIDS pandemic may be profoundly eroding the ability of institutions to meet such demand. Indeed, the disease is having devastating effects on the social and institutional fabric of the region. From planning processes in central government to agricultural extension programs at the village level, a multiplicity of tasks may not be completed appropriately because of deaths, disease-related absenteeism, increases in workload, low morale, loss of institutional memory and other undesirable mechanisms that weaken institutional capacity.

The need to address institutional capacity for climate change adaptation in the region has been highlighted in numerous occasions. The African Union (2007), in its “Decision on Climate Change and Development in Africa”, committed to strengthen current African Regional and Sub-regional climate centers of excellence, as well as to develop and strengthen research and development to increase the continent’s resilience and adaptation to climate change. The Intergovernmental Panel on Climate Change (IPCC 2001) identifies the enhancement of institutional capacity as one of the key determinants for adaptation. The Poverty Reduction Strategy Papers of Malawi (Malawi Government 2002) and other countries in the region make a very strong case for articulating HIV with every factor affecting poverty reduction initiatives, including the ability to prepare for and cope with an increasingly variable climate. As Thomalla et al. (2006) point out, the disaster risk reduction community needs to play a substantial role in the institutional approach to climate adaptation.

The dominant discourse of climate change adaptation explicitly expects state-led promotion and implementation of adaptation initiatives in developing countries (Eakin and Lemos 2006). Substantial institutional transformations are needed to integrate climate change, disasters and development (Schipper and Pelling 2006). In particular, a change in institutional structures and relations is needed for disaster policies and their implementing agencies to properly address climate change (O’Brien et al. 2006). This will require maximizing the potential for institutional change at different policy scales (Tompkins and Adger 2005). Yet these kinds of changes are not easy to implement in the developing world. A key task now is to progress from rhetoric to action (Ogunseitan 2003). It is indispensable to better understand the relationships between institutional change, adaptation needs and HIV/AIDS threats to organizations involved in disaster management.

Figure 1: Demand and organizational capacity for disaster management. Capacity is declining due to HIV/AIDS-related staff attrition, while demand is growing due to climate change, increasing the gap between what disaster-related institutions need to offer and what they can deliver. Decisions made today will define the future magnitude of that gap.

A basic framework for addressing this issue is presented in Figure 1. There is currently a gap between the capacity of disaster-related institutions and their capacity to meet such demand. For example, the Malawi Agricultural Extension Service has defined a standard ratio of 500 farmers per extension worker as the adequate level of workload for each worker to properly assist rural communities. Yet our study found that the number of extension workers has been declining (due to AIDS-related staff attrition and other causes) and the current average ratio is 1,603 farmers per extension worker. For Lilongwe the ratio is 1 : 2,164, meaning less time spent with each farmer (see detail in section 6.4). On the other hand, changing rainfall patterns require farmers to modify their agricultural practices, and extension workers should be spending undergoing more training on climate change impacts on agriculture and adaptation options, and spending more time with each farmer to promote adequate adaptation measures. The ratio should probably be closer to 450 farmers per extension worker. The demand for services is growing with climate change, but the capacity is declining with the HIV/AIDS pandemic and other factors. At a minimum, it would be necessary to stop staff attrition. Ideally, there should be enough investments in human resources and other assets to ensure that capacity meets demand.

Little is known in southern African countries about how the disaster management sector is being affected by HIV/AIDS. Substantial research has been conducted on the impacts of the pandemic on a variety of other sectors, including primary education (Bennell 2005), health (McCourt and Awases 2007), communal fishing (Allison and Seeley 2004), the business sector (Guinness et al. 2003) and even police services (UNDP 2002). Many of these sectors are assessing institutional needs in the face of the pandemic (e.g. Piot and Peck 2001). For example, Malawi has launched a new initiative to revert the collapse in health services since 1990, particularly regarding staff levels (Palmer 2006). It is vital to know how disaster-related institutions are being impacted by the HIV/AIDS pandemic at a time when their roles in promoting climate adaptation become increasingly crucial.

This paper examines the combined effects of climate change and HIV/AIDS on disaster management in Malawi, a country where the majority of the population depends on rainfed agriculture (making it very vulnerable to climate change), and with one of the highest HIV prevalence rates in the world. The remainder of the paper is structured as follows: Section 2 offers background information about the magnitude of the pandemic in Malawi, and presents key concepts for analyzing the effects of HIV/AIDS on institutions. Section 3 provides an overview of observed and projected climate change and its implication for disaster management in the region. Section 4 highlights dreadful “synergistic” mechanisms by which the combined effects of climate change and HIV/AIDS are greater than the sum of their separate effects. Section 5 introduces the six key Malawian institutions involved in disaster-related work selected as case study for this research: four government agencies and two NGOs. Section 6 describes the proposed approach to analyze the relationships between capacity and demand, and presents evidence of the problem. Section 7 concludes by discussing implications for climate change adaptation in Malawi and the region, formulating recommendations for institutions, donors, policymakers and practitioners.

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