Swaziland’s HIV/AIDS epidemic has been characterized by the slow onset of a myriad of
co-factors culminating in a chronic emergency, burdening every sector of society.
Exacerbated by domestic political mismanagement and ill-suited policies of international
organizations, impacts will remain endemic for generations.
From near-zero diagnosed HIV infections in 1990, Swaziland now has the highest relative
prevalence in the world. The impacts of infection are withering the human capacity to
mount effective and systemic interventions. Indicators of social well-being show a
population in distress. Aggravated by gender inequality, drought, agricultural decline and
insufficient financial resources, livelihood failure in Swazi households has become
commonplace – and the situation is deteriorating.
This article argues that the brutal reality facing the Swazi population is perpetuated by the
lack of political will of government and conditionalities imposed by international donors.
In the absence of comprehensive government-led programming, many communities have
initiated interventions. Assisting these vulnerable populations requires sustained
international financial commitments. This money would be used to best effect if
accompanied by pressure for domestic political accountability in Swaziland. Such changes
will facilitate country-wide interventions, particularly those at the community level. While
Swaziland is the case study, many of the findings are applicable to generalized epidemics
throughout southern Africa.