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The losing fight against AIDS

Two days after World AIDS Day I’m writing from Swaziland, where statistically there is at least one person dying in every single household. Statistics on HIV & AIDS prevalence in Swaziland vary from between 47%, as some UN agencies once claimed, to 26.5%, the official government statistic. In the 18 to 24 years age range it is estimated to be one in two people. At best this is more than one in four people. If you look around you now, this is an impossible concept to grasp.

Poverty and inequality drive both the HIV & AIDS pandemic and malnutrition levels in country and the link continues as under nutrition further weakens the immune system and increase illness of those who are suffering. For those already infected with the virus, malnutrition and opportunistic infections exacerbate one another in a vicious cycle that speeds the progression from HIV to AIDS. Our work in Swaziland, as in many countries in the region, makes a vital contribution to efforts to find solutions to these problems.

During the workshops described in my previous entry we worked with participants to draw up a picture of the past six months, including critical events, food and income patterns and the way in which this has impacted the community. The monitoring following the project shows encouraging adoption of banking practices, albeit by a few, and there are positive signs of improved ability to cope during the months immediately following the project. For many of the households involved, the project offered the support that was needed. It allowed those affected temporarily by drought to regain, maintain and rebuild their income and food security. There are positive indications that households are accessing a broader range of financial services, with some households using their bank accounts to receive money from outside of the country – remittances from relatives working over the borders. Cash investments made in livelihoods activities have for many provided a consistent source of income that will protect them during the coming months.

Unfortunately for the many households living in chronic poverty, the little that they were able to save during the programme rapidly depleted during the months of May and June, along with the stored food stocks. In the face of limited harvest, increased food prices, a 50% increase in transport costs, forest fires and reduced labour opportunities these households are suffering once again. For those suffering from HIV & AIDS the combination of reduced access to healthcare (transport costs), hunger and extreme weather caused sickness and fatalities. Workshop participants reported a rapid reduction in local availability of vegetables and food items in the months following the project – with markets retracting as local tradesmen were no longer able to support their business. For children reduced food intake and dietary diversity have resumed.

It is clear that annual food distribution is not the best answer for these households and that alternative solutions need to be sought in order to reduce the suffering and stabilise the condition of the most vulnerable households. I have had some positive meetings with donors and with government ministries here and slowly different options are being considered. The cash programme has assisted in guiding alternative thinking and we hope through future proposals to be able to further assist these communities with a sustainable solution. Tomorrow I return to the UK but the Hunger Team will continue to support the potential development and implementation of a social protection scheme in Swaziland over the coming years.

It has been great to revisit Swaziland. I even managed to squeeze in an Oliver Mtukudzi concert on Friday night. For those who know him, yes of course, he was great! For those who do not: shame on you! (He is the most famous musician in Zimbabwe). Although clearly reminded of the dark side of this beautiful country, I leave feeling positive about future endeavours and important partnerships formed by Save the Children Swaziland following the cash transfer programme.

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