Swaziland has the highest rate of HIV infection in the world.
According to official figures published this week 42 percent of pregnant woman are HIV positive. Other surveys put the number of those infected as closer to one in five of the entire population of one million. If this prevalence rate was applied to the United States, then more than 56 million Americans would be infected.
Deaths from AIDs-related illness have devastated Swaziland. AIDS kills half of the children dying under the age of five. Swazi citizens born in 1993 could expect to live 60 years; today Swaziland has the lowest life expectancy in the world at just 31.3 years.
A report from the International Monetary Fund (IMF) this month (February 2009) estimated that a quarter of Swaziland's workforce is absent from work because of HIV AIDS. The IMF attributed job absenteeism to people suffering from HIV AIDS as well as those staying home to care for people sick with the disease. According to UNAIDS, about 26 percent of Swaziland's sexually active population are infected.
Figures are hard to confirm in Swaziland because the country is rural and accurate records are not kept, but it is estimated there are 130 000 orphans and vulnerable children in Swaziland and this figure is expected to rise to 200 000 by 2010.
Maybe as many as one in four children under the age of 18 are orphans and there are about 3,000 households in the kingdom headed by children, because their parents have died of AIDs-related illness.
As elderly caregivers die, the oldest children take over without a support network.
Swazi women and girls shoulder the burden of the disease and are the most vulnerable to infection. A shocking 49 percent of women aged between 25 and 29 are thought to be HIV-positive, reflecting the low status of women.
HIV has taken hold in Swaziland in part because people are desperately poor and unable to feed themselves adequately. This leaves them open to infection and when they become HIV-positive anti retro viral drugs cannot work on malnourished bodies.
Poverty is endemic to Swaziland. About seven in ten people earn less than one dollar a day and about 650,000 people rely on food aid from international donors to survive. The United Nations Development Programme reports about four in ten people are moving from hunger towards starvation. AIDS has severely affected the Swaziland’s food security by decimating the ranks of agricultural workers, especially adult male heads of small subsistence farms.
Official statistics show that 22 percent of the population in Swaziland is undernourished; nearly 15 percent of children under five are underweight; and more than 16 percent of children born in Swaziland die before their fifth birthday. About four in ten children are so malnourished that their growth is permanently stunted.
HIV education doesn’t seem to be working. A survey in 2007 found that 99 percent of survey participants said they knew about the disease, but nearly half admitted having multiple sex partners and having sex without condoms. Meanwhile, four in five Swazi men refuse to be tested for the HIV virus.