HIV/AIDS+WORK Swaziland

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4Swaziland: HIV/AIDS work and developmentless than 25 years old and about 87% of thoseinfected were under 30 years of age. As withthe adolescents mentioned above, this highlevel of infection among young females reflectsa high rate of new infections (incidence). Ifthese trends persist, they will have a severeimpact on the socio-economic fabric of thecountry, since this age group represents theeconomically-productive and -reproductivepopulation.Equally high HIV prevalence rates havebeen recorded among married and unmarriedpersons—36.8% and 40% (2002) respectively.This shows that people get infected very young,even before the mean age of getting married.ii. Factors contributing to the spread of HIVinfectionSome cultural expectations and genderrelations have been found to contribute to HIVtransmission—in particular those that increasewomen’s vulnerability.In Swazi society women lack bargainingpower to negotiate safe sex, and polygamy iscommon which greatly increases women’s riskof contracting HIV. The 2002 survey found that,of those who tested positive for syphilis, 53%were HIV-positive; and among those who testednegative for syphilis, 38% were HIV-positive.This trend has also been observed inBotswana, resulting in the infection beingpassed from one generation to the other. TheGovernment of Botswana noted that, in moreadvanced epidemics, stopping the spreadof HIV from one generation to another is oneof the key interventions required. Given thatprevalence rates have been found to be 4–12times higher in young females than youngmales, this means stopping the spread fromolder men to girls.Belief in witchcraft: This tends to delayproper treatment of the villagers who areinfected with fully blown HIV/AIDS. It has beenseen that when they reach the hospital it isusually too late and some of the local healersadvice them to sleep with an innocent baby toget rid of HIV/AIDS (quoted from the Ministryof Labour).Wife’s inheritance: If a person dies of HIV/AIDS, it is customary that the younger brother‘marries’ the widow of the dead brother in orderto bring up the children. He in turn, almost7 See the World Vision website: www.wv.org.za/countries/swaziland.htm8 Alan Whiteside & Nkosinathi Ngcobo, Jane Tomlinson, & Alison Hickey (March 2003), “Whatis driving the HIV/AIDS epidemic in Swaziland? And what more can we do about it?” NationalEmergency Response Committee on HIV/AIDS and UNAIDS.never ensures whether the widow is infectedwith HIV, in which case his wife gets infected.Church attitudes: Some churches are stillreluctant to teach the people about HIV/AIDS.They insist that the answer to HIV/AIDS isacceptance of Christ who will empower thebeliever to abstain and live a holy life.Low level of condom use: Condoms aregenerally available in the country but theirlevel of use is low, due to widespread mythsabout them. Furthermore, in Swazi society, theyouth become sexually active early in life. In a‘knowledge, attitudes and practice’ baselinestudy conducted by Family Life Association ofSwaziland and the United Nations Children’sFund (UNICEF) in 2001, 45% of young peoplereported being sexually active and felt that 70%of their friends were also sexually active. Mostparents thought that young people engagedin early sexual activity (as evidenced by earlypregnancies).Poverty: Poverty assessment surveyscarried out by the World Bank and the UnitedNations Development Programme (UNDP) showthat 66%of Swazis live in absolute poverty. Forrural areas, the percentage of people living inabsolute poverty is even higher at 80%. Thedata show high inequalities in the distributionof income, with 10% of the population obtaining60% of the country’s income, and 90% of thepopulation receiving only 40% of the income.This ever increasing gap is indicative of highlevels of poverty in the country which arefurther exercerbated by the high rates of HIV 7 .Also, poor nutrition and bad general healthamong the people make their body’s immunesystem less able to fight infection. Therefore,the virus is more likely to gain a hold. Thereis also evidence of gender discrimination inaccess to health care, with women not alwaysgetting the medical attention or treatment thatthey need.Lack of information: A behavioural surveycarried out in 2003 8 concluded that the Swazipeople are highly knowledgeable about HIV/AIDS/STIs, even though this knowledge has nottranslated into desirable behavioural change.As a result, there is a need for clarificationabout protection from HIV, update on provisionstargeting young people, efforts at demystifyingpopular myths to avoid stigmatization amongpeople who are inaccurately informed.Vulnerable groups: Income inequalityincreases the likelihood that poor women willbe forced into transactional sex as a survivalstrategy. Orphans and vulnerable children aremore likely to be exploited and this may includesexual exploitation and abuse. In Swaziland,youth that do not find formal employment
are forced into poverty and lack access toopportunities and resources, contributing totheir vulnerability to HIV.Migration: Migration has been a causalfactor in the spread of HIV infection in manycountries in Africa. According to a census inSwaziland (carried out by ILO/SAMAT—theSouthern Africa Multidisciplinary Advisory Teamof the International Labour Organization), therewere 51,000 absentees—mainly men workingin South Africa in the late 1990s.Census data(1997) show that the Shiselweni region hasthe highest levels of emigration, with over 90%of people migrating to the Manzini region. Astudy on subsistence agriculture farms showedclose correlation between migration andHIV prevalence and AIDS deaths. It showedthat the Shiselweni region had the highestnumber of AIDS-related deaths, followed bythe Manzini region, but the Shiselweni regionhas the lowest prevalence of HIV (27%), andthe Manzini region the highest (41%). Thisis because of the migration pattern withinShiselweni and the lower socio-economicstatus of the region. Those who migrated fromthe Manzini region could have acquired theinfection elsewhere and only returned home todie. This study revealed that many householdsreported family members returning home inthe terminal stages of the disease.3. Demographic impactThis section presents an analysis ofprojections made by ILO on the dimension ofhuman losses faced by Swaziland, and theirconsequent impact on the labour market 9 .However, these projections are rough estimates.They may provide a benchmark around which toframe national policies but should be used withcaution. It must also be noted that these datamake no distinction between the participationof those in the labour force who are affected/infected by HIV and those who are not. Thisis problematic since HIV/AIDS may havesignificant consequences—for example, lowerparticipation of infected workers, and increasedparticipation of non-HIV-infected workers andrelatives of those infected. The lack of data onthe informal sector is also important, as thisis where most people in urban areas work,and informal activities provide a livelihood formillions of inhabitants.three years of depressed food production andrural incomes. The estimated life expectancyat birth according to recent estimates (2004)is 37,5 years 10 . The population growth rateis 0.55 (2004 est.) Furthermore, the currentimpact of the HIV/AIDS pandemic is exactinga very heavy burden on the population and theeconomy. The peak ages for HIV/AIDS (andresulting mortality) are 25–35 for women, and30–40 for men. (ILO projections, see figure 5).Economically and biologically, these are themost productive years in a person’s lifetime.But the potential to produce and reproduce isreduced as the epidemic sweeps away youngadults who would otherwise be key contributorsto household and national production.This has resulted in lower life expectancy,higher infant mortality and death rates, lowerpopulation and growth rates, and changes inthe distribution of population by age and sexthan would otherwise be expected (July 2004est.). The following projections by the ILO showa breakdown of how and where exactly are thelosses in population located.Figure 2. Impact of HIV/AIDS on population growth160014001200100080060040020001985 1990 1995 2000 2005 2010 2015 2020i. Impact on the labour forceThe projections in Figure 2 show thatpopulation growth over the past two decadeshas been seriously undermined by AIDS. Somepopulation growth continues, but at greatlyreduced levels Figure 3 shows AIDS has amajor impact on the work force; it is projectedthat, by 2005, the HIV/AIDS-related lossesin the labour force can be calculated to beabout 10%, rising to 30% by 2020 . The figureis a projection for the total labour force (aged15–49) from 1985 to 2020. Even though thePOP(With AIDS)POP(No AIDS)The 2004 Human development reportclamps down Swaziland with a HDI of 0.51,an index which combines measures of lifeexpectancy, school enrolment, literacy andincome. The levels of human developmentindicators have considerably worsened given9 UN Population Division, World Population Prospects, the 2000 Revision, New York, 2001. Theestimates used for these projections are from the ILO Labour and Population Programme. Thoughlabour force data are available for workers from the ages of 10 to 65+, this paper only addressesthe active labour force of 15–49-year-olds. Labour force participation rates, from UNAIDS, areused to make labour force projections. These projections have been now updated (2004) and areavailable at ILO/AIDS HQ Geneva.10 http://worldfacts.us/Swaziland.htmSwaziland: HIV/AIDS work and development5
Page 1 and 2: HIV/AIDS+WORKSwaziland:HIV/AIDS, wo
Page 3 and 4: AcknowledgementsThis report was dev
Page 5: ContentsExecutive summary 1A. Situa
Page 8 and 9: A. Situation analysisPiggsPeakMhlum
Page 12 and 13: Figure 3. Age-wise loss in the acti
Page 14 and 15: B. Economic impact of HIV/AIDS12 So
Page 16 and 17: 16 Pension annuity refers to on-goi
Page 18 and 19: 30 Muwanga FT (2001) Private sector
Page 20 and 21: Table 4: Companies that have workpl
Page 22 and 23: C. Policy optionsDeveloping a polic
Page 24 and 25: D. RecommendationsThe commitments o
Page 26: ISBN-92-2-117159-0ILOAIDSInternatio

HIV/AIDS+WORK Swaziland

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