Service Contract No 2007 / 147-446 Strategic ... - Swaziland

In general, however, the HIV prevalence level is said to be stabilising. According to HIV serosurveillancesurveys of women attending antenatal clinics, HIV prevalence rose from 3.9% in1992 to 42.6% in 2004, dropped slightly to 39.2% in 2006, rising slightly in 2008 to 42.0%(Ministry of Health, 2008a). A number of factors have contributed to current trends, such asan improvement in the quality and extent of support provided, with more households havingaccess to and receiving information, training and medical supplies (Kingdom of Swazilandand European Commission, 2005a). On a societal level the stigmatising attitude towards thedisease has diminished, creating the space for greater openness towards being tested andtreated.National policy development has played a significant role, not only in recognition of thedisease, but particularly in its management:- Initially the government responded to the disease through the health sector, and theSwaziland National AIDS Programme (SNAP) was established in the MoH in 1989.Guidance for HIV/AIDS was presented in the form of short-term and medium-termplans and a health sector policy document in 1998. These focused on blood safety,public awareness, safer sexual behaviour, the prevention of Sexually TransmittedInfections (STIs), Voluntary Counselling and Testing (VCT), community Home-BasedCare (HBC), the management of opportunistic infections such as Tuberculosis (TB),the promotion of support groups to People Living With HIV and AIDS (PLWHA), andthe mobilisation of young people in their understanding of the disease.- The National Emergency Response Council on HIV and AIDS (NERCHA) wasestablished by Government in 2001 as a Committee under the Prime Minister’sOffice, and became a Council by Act of Parliament No. 8 2003 37 . NERCHA’smandate is to co-ordinate and facilitate a national response to HIV/AIDS, to overseethe implementation of the National Multisectoral Strategic Plan (NSP) for HIV andAIDS, and to develop the National Multisectoral Strategic Framework (NMSF) for HIVand AIDS 2009-2014. The NMSF describes a 5-year framework for HIV/AIDS,informed by the National Multisectoral HIV and AIDS Policy (2006) and lessons learntthrough the Second National Multisectoral HIV and AIDS Strategic Plan (NSP II 2006-08): to scale up/mainstream response strategies. In addition, NERCHA developed acomprehensive National Monitoring and Evaluation System, which outlines the goals,objectives, indicators, data sources and reporting arrangements required formonitoring HIV prevalence, and the country’s programmatic response.The policies have been developed in the context of a number of key international andnational documents.On an international level, of significance are the Millennium Development Goals (MDGs),commonly accepted as a framework for measuring development progress, and for guidingfunders in determining their development assistance 38 . The goals are directed at reducingpoverty through specific targets based on indicators; Goal 6 is to Combat HIV/AIDS, malariaand other diseases.On a national level, apart from the plans and strategies mentioned above, governmentpublications include the National Development Strategy (NDS) (2002), the National FoodSecurity Policy for Swaziland (2005), the Poverty Reduction Strategy and Action Plan(PRSAP) (2005 revised draft), the Strategy Brief for National Food Security and AgricultureDevelopment (2005), and the Swaziland Annual Vulnerability Assessment and AnalysisReport (2009).37 Pamphlet: What is NERCHA: A Nation at War with HIV/AIDS.38 www.undp.orgRDMU (Strategic Environmental Assessment of the National Adaptation Strategy) - Page 77