Climate-Smart Agriculture, HIV and Food Security: A Policy Analysis of Nutrition Outcomes in Lesotho, 2021–2026

This policy analysis examines the integration of climate-smart agriculture (CSA) within Lesotho’s national HIV and food security strategies from 2021 to 2026. It addresses the critical gap in understanding how agricultural policy, in a context of climate vulnerability and high HIV prevalence, can be coherently leveraged to improve nutrition outcomes for affected households. The study employs a rigorous qualitative document analysis of key policy frameworks, including Lesotho’s National Strategic Development Plan II and the National Nutrition Strategy. A systematic search and selection protocol was followed to identify relevant programme evaluations and peer-reviewed literature, which were analysed using a structured thematic approach. The findings reveal that while policy rhetoric acknowledges the syndemic of climate change, HIV, and malnutrition, operational integration remains fragmented. Specifically, CSA initiatives such as conservation agriculture and drought-resistant crops show potential for enhancing dietary diversity, yet their implementation often fails to prioritise nutritional targeting for people living with HIV. The significance of this analysis lies in its demonstration that siloed policy approaches undermine the potential for CSA to bolster food security as a critical determinant of health. Consequently, the study advocates for a revised, cross-sectoral policy framework that explicitly links agricultural extension with community health programmes, ensuring climate resilience directly supports the nutritional resilience of HIV-affected households.