Global Policy Forum

A senior UN official on Friday confirmed that Swaziland now has the world's highest rate of HIV infection, at 38.6 percent.

"Botswana has made a very strong claim that they have lowered their infection rate from 38.8 percent to 37.5 percent. That leaves Swaziland with the world's highest rate of HIV infection," Stephen Lewis, the UN Secretary-General's Special Envoy for HIV/AIDS in Africa, said at the conclusion of a three-day tour of the country.

He expressed satisfaction that the scope of the crisis was now recognised by national leaders and health organisations. "There should be an absolute devotion to HIV/AIDS in every human endeavour in Swaziland over the next few years. It is a battle the world wants you to win," Lewis said.

Lewis recalled that on his previous visit, 60 percent to 70 percent of the beds at the central Mbabane government hospital were filled with AIDS patients. "Today, doctors said the figure is 90 percent. People are sleeping under beds. It is a manifestation of the havoc brought by the pandemic," Lewis said.

The envoy was particularly struck by the growing population of Swazi children orphaned after their parents died of AIDS. "The incredible reality of orphans is something I never felt more strongly visiting any other country. I was told by the prime minister that by 2010 there will be 120,000 children without parents because of AIDS," Lewis said.

The envoy delivered the news of Swaziland's world-beating ranking in HIV infections at a meeting with King Mswati on Thursday. The Times of Swaziland reported Mswati's reaction. "We do not wish to be the highest country in the world when it comes to the issue of HIV infection, hence we have embarked on a number of countless projects to deal with the effects of the scourge," the newspaper quoted Mswati as saying.

On Friday, Lewis told health organisation leaders to speak up on the subject of AIDS. "I'm not counseling action in the streets, but with HIV/AIDS you have to be forceful with political leaders. You can even be forceful with kings. You are fighting for your survival, for God's sake," Lewis said. The envoy was especially impassioned on the need for gender equality to combat the disease. "There are many facets of culture, but there is a universal truth, and that is the need for gender equality," he said. "Women must have the right to say no (to sex), the right to insist that men wear condoms."

Lewis praised Swaziland's initial steps to introduce antiretroviral drugs to prolong the lives of HIV positive people. He was impressed that the World Health Organisation (WHO) was gearing up in Swaziland to facilitate the UN's "3 by 5" initiative, whereby three million HIV positive people worldwide will receive treatment by 2005. "This is the most dramatic single development in years. But it is just a beginning," he said.

Lewis said WHO was working with Swaziland's Ministry of Health on capacity building and training, and identifying areas of the healthcare system infrastructure and the medicine delivery pipeline that need to be improved.

Lewis criticised the world community for doing little other than watch for 20 years as AIDS swept across Africa. "How in God's name has the world allowed this to happen? It is a crime. But it's changing. There is a willingness now to help," he said.