PlusNews (Johannesburg)

South Africa: Failing Healthcare System Renews HIV Activism

Mbabane — A new wave of HIV activism is rising in Swaziland as people living with HIV take to the streets in protest, many for the first time in their lives, over continued shortages of antiretroviral (ARV) treatment.

Swaziland 's deepening financial crisis is taking a toll on service delivery, and the country is experiencing an unprecedented number of protests over issues such as school closures and a lack of HIV treatment. While Africa's last absolute monarchy does not allow formal political opposition to operate, a new brand of HIV activism may be taking hold as anger mounts over a lack of ARVs.

"People living with HIV and AIDS are more politically active," said Thandi Nkambule, director of the Swaziland Network for People with HIV and AIDS (SWANEPHA), an umbrella body. He noted that there are similarities between Swaziland's newfound HIV activism and established movements in neighbouring South Africa.

"The leaders of the HIV support groups are joining the marches because they know that [government] leadership lacks the political will to meet the needs of people living with HIV and AIDS." About a quarter of all adult Swazis are living with HIV and about 47,000 patients nationally were on ARVs at the end of 2009, according to UNAIDS.

Shortages of HIV programme supplies in Swaziland began making headlines in mid-2011. Media reports have largely attributed stock-outs to reduced revenues from the Southern Africa Customs Union (SACU), but the country also opted not to apply for funding in Round 10 from the Global Fund to Fight AIDS, TB and Malaria. Instead, it chose to assume financial responsibility for HIV treatment itself, at a time when SACU revenues were already projected to decline. Domestic funding has proved insufficient to back this decision.

Rising voices on the ground

Thandi Khumalo has been on ARVs for a year. Earlier in 2011 she took part in her first trade union protest as part of a "Week of Global Action" to press for political reform in Swaziland.

"The clinic where I go has never run out of ARVs, like some other places that have been hit by the government financial crisis, but I know people in our support group who have experienced interruptions," she said during a demonstration.

More on Swaziland

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Funding fiasco leaves country short of lab supplies

"I have never been involved in politics... [but] we all live in fear that this will happen to us - that is why I am doing this political march. Something has to change in the way this country is run, or we will die," Khumalo told News. "This is survival for me."

The Ministry of Health has disputed allegations that Swaziland is experiencing sporadic shortages of ARVs, and Health Minister Themba Xaba recently said anyone experiencing stock outs should contact him personally. The minister also alleged that pro-democracy groups have used allegations of ARV stock-outs for political gain, but activists disagree.

"The shortages of medicines and basic supplies in hospitals are real - that is why the nurses staged a protest action this year," said SWANEPHA member Solomon Thwala, who added that SWANEPHA members have been verifying and reporting stock-outs that the government continues to deny.

In August the US President's Emergency Plan for AIDS Relief (PEPFAR) gave the country US$7 million in emergency funding, but this was only for first-line ARVs. Swaziland now has a buffer stock of first-line ARVs that should last until April 2012.

Prudence Simelane, a garment worker, also joined demonstrations to protest shortages of the drugs that she says have given Swazis hope, but which she feels can no longer be entrusted to government. "Swazis never cared about AIDS - they were told they would die if they got HIV and there was nothing they could do - but now we can live with HIV."

She surprised herself by joining in recent demonstrations. "We have hope because of the ARVs - people are thinking about their lives, and about the future," Simelane said. "That is why we are so frightened - because we can't trust government to keep us supplied with drugs."

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