Document Type

Migration and Development (MAD) Series

Publication Date



Balsillie School of International Affairs


This publication seeks to establish a background for understanding the complex and dynamic linkages between urbanization, migration, HIV/AIDS and urban food security in Southern and Eastern Africa (SEA). As urbanization accelerates, direct food transfers from rural areas are increasing as poor urban households seek to reduce their vulnerability to high food prices and a cash-intensive urban existence. At the same time, urban households or individual migrants remit money back to households in rural areas both inside and outside the country of employment. A significant proportion of remittances are used for consumption purposes, including the purchase of food. These processes are underwritten by various forms of rural-urban, cross-border and circulatory migration.

Migration has clearly facilitated the rapid spread of HIV in the SEA region over the last two decades. For a number of reasons, migrants and other mobile people are especially vulnerable to HIV/AIDS. The epidemic, in turn, is leading to new forms of migration, including children’s migration and return migration of PLWHAs (People Living with HIV and AIDS) to rural areas. Not only does this lead to a decline in remittances but it places a greater burden on rural households. Rural food production for urban household members may also be negatively affected by the impact of HIV/AIDS on rural producers. In the context of HIV/AIDS, migrants themselves may be unable to pursue other food security avenues, including urban agriculture.

As HIV/AIDS creates both short term and long term intergenerational impacts within the framework of its long wave epidemiological pattern, the development context is changing considerably. In order to formulate appropriate policy responses, it is therefore imperative to understand the complex linkages and transfers of people and commodities which characterize the “new social economy of migration” in the SEA. At the same time, it is important to understand the inter-related connections between migration and HIV/AIDS for two basic reasons. First, migrants are a particularly vulnerable group, both to HIV infection and to resultant food insecurity. Second, a disease which eats away at the fabric of the new social economy of migration will severely test the ability of urban and rural areas to provide a secure food supply for their populations, both at the aggregate and household levels.

It is against this backdrop that this publication documents the key dimensions of the complex connections between urbanization, migration, HIV/AIDS and food security. There is an existing and growing literature on some of these connections; between migration and HIV/AIDS, for example, and between HIV/AIDS and rural food security. However, the linkages between HIV/AIDS and urban food security are less well-established. In addition, attempts to link both HIV/AIDS and urban food security simultaneously with migration are only now being considered, and this project is the first to examine these dynamics at the regional level. That task is rendered more challenging by the fact that migration itself has been undergoing rapid changes in form over the last decade.

The publication is divided into three sections. It is designed to lay the foundation for further discussion and the articulation of a targeted action research agenda which addresses both the knowledge gaps and the policy and programming needs of the region in this field of development.

This paper begins by reviewing the literature on urbanization and migration in SEA, showing how rapid urbanization is not eliminating migration but intensifying its scope and scale. The section also provides an overview of the HIV/AIDS epidemic in SEA and seeks to establish the reciprocal connections in the HIV/AIDS and migration nexus. Finally, the section reviews current evidence on the determinants of food security in urban areas.

The second chapter focuses on the links between migration and HIV/AIDS, migration and food security, and HIV/AIDS and food security. Research on these sets of linkage is proceeding apace although much more is known about the impact of HIV/AIDS on rural than urban food security.

The third chapter draws together these sets of relationships and outlines the key knowledge gaps and emerging research questions for the region. Although the research literature is not yet developed in this regard, various conceptual models have been devised to help understand these relationships.

Although some of these models focus on rural food security and some on urban, this paper argues that the distinction is artificial, and that migration is the “missing link” between the urban and the rural. Migration links the rural and the urban social economies and emphasizes the point that urban food security cannot be isolated from rural food security and vice-versa. Finally, the paper proposes some next steps in developing a fully fledged and policy-relevant research agenda.