Authorities in Swaziland want to subject the entire Swazi population to a HIV/AIDS screening test. Those eventually found to be HIV positive would then receive antiretroviral drugs (ARVs). It is an ambitious project involving various donors including the Dutch organization, Stop Aids Now! But is it possible to test an entire population?
Nearly 200,000 of Swaziland’s 1.2 million inhabitants are HIV positive, which makes the southern African country the world record holder for HIV prevalence. Moreover, many Swazis have never been tested for HIV before. The number of people living with the virus that causes AIDS could thus be much higher. HIV/ AIDS expert, Joep de Lange, from the University of Amsterdam, is among the supporters of the project.
According to him, the screening test could lower the prevalence of the pandemic to one percent of the Swazi population. But he remains cautious: “You cannot force people to use ARVs. Continuous monitoring is necessary. But it is a promising strategy in the fight against the pandemic”.
Is it really possible to conduct a screening test on such a scale? Swaziland is one of the smallest countries in Africa, stretching over 200km from North to South and 130km from East to West. Only people above the age of 15 will be tested. A monumental task indeed, but not an impossible one according to local authorities.
Dutchman Ton Vriend has been living in Swaziland since 1976. He has been involved in numerous health projects and is skeptical as regards the feasibility of such a campaign. “I don’t think it is possible to provide drugs to all patients. Moreover, a checkup will only be possible in cities, where the clinics are, and people living in rural areas cannot generally afford to get there”.
Swaziland has some experience when it comes to large scale screening tests. Part of the population has already been tested in various rural areas such as the areas around sugar cane plantations.
Unlike many other African countries, HIV/AIDS is no longer taboo in Swaziland. However, according to Vriend, a there is still a lot to be done with regard to protection measures against the virus.
Vriend: “In the cities, condoms are widely available. However, in remotes areas, people sometimes have to walk for several kilometers to acquire them and sometimes they are already used. People here have a different kind of sexuality”.
Swaziland would nevertheless make history, as no other country has ever subjected its entire population to an HIV screening test.
However, there are protests in Swaziland over shortage of drugs. Hundreds of people have taken to the streets to protest against poor governance which has led to a shortage of essential medical supplies. More than 500 people demonstrated in Mbabane, the capital, on Wednesday while nearly 1,000 protested in the western town of Siteki.
AIDS groups have warned of an imminent shortage of anti-retroviral drugs in a country where a quarter of the people between the ages of 15 and 49 are believed to carry HIV.
However, it’s not just a shortage of drugs which is causing problems. Many are eating manure to make their medication work. Too poor to afford food, those lucky enough to receive ARV’s have resorted to eating dung to fill their stomachs because the drugs don’t work on an empty stomach, so patients are mixing dung with water to help them digest it.
Aid workers are shocked to see how people have been forced to live, said Siyabonga Sithole, from the Swaziland Network of People Living with HIV and Aids.
“HIV patients are told their drugs will not work unless they have something in their stomachs – but many people are suffering an economic crisis, which means they are unable to buy food,” he told the Swazi Observer newspaper.
“I first saw two months ago residents drying cow dung and mixing it with water to eat before they take their pills. I was told three or four people were doing this but since then the number has grown. This is very disturbing and it’s an indication of how bad the situation has become,”
Eating cow manure is most common in the eastern Lubombo region, which has suffered a long stretch without rain, and where up to half of the population is HIV positive.
Hundreds of people are protesting in the southern African country, claiming that poor management by sub-Saharan Africa’s sole absolute monarch has caused a shortage of essential medical supplies and a failing economy.
Swaziland is one of the world’s HIV capitals – a quarter of adults among its 1.2million people are HIV positive. The virus has killed many workers and farmers and has created thousands of orphans. Many have been given antiretroviral drugs – but these could soon run out as the economy collapses. Aids groups have already warned that the country faces a shortage of anti-retroviral drugs.
About 70 per cent of people in Swaziland are so poor they live in abject poverty, earning less than £1.20 a day. At least one third of the one million population get some sort of food aid each year.