The HIV/AIDS Epidemic in Swaziland October 2005
Swaziland has the highest HIV/AIDS prevalence rate (the percent of people living with the disease) in the world, a much higher rate
than the sub-Saharan African region overall (38.8% compared to 7.5%). Moreover, a recent survey suggests that HIV prevalence
rates in Swaziland continue to increase. As of the end of 2003, there were an estimated 220,000 people living with HIV/AIDS in
Swaziland, or almost 4 in 10 adults.1 The epidemic has already had a profound effect in Swaziland, posing significant development
challenges to this middle-income country.2,5,6,7 The Government of Swaziland created the Swaziland National AIDS Programme in 1987
to respond to the epidemic and declared HIV/AIDS a national disaster in 1999. In 2001, the National Emergency Response Council
on HIV and AIDS (NERCHA) was established, and the National AIDS Strategic Plan for HIV/AIDS 2006 - 2008 is currently under
Figure 1: Percent of Adults Estimated to be Living Figure 2: Number of People Estimated to be Living
with HIV/AIDS, 2003 with HIV/AIDS, 2003
Swaziland 38.8% South Africa 5,300,000
Botswana 37.3% Nigeria 3,600,000
Lesotho 28.9% Zimbabwe 1,800,000
Zimbabwe 24.6% Tanzania 1,600,000
South Africa 21.5% Mozambique 1,300,000
Namibia 21.3% Kenya 1,200,000
Zambia 16.5% Dem. Republic of Congo 1,100,000
Malawi 14.2% Zambia 920,000
Mozambique 12.2% Malawi 900,000
Tanzania 8.8% Uganda 530,000
Kenya 6.7% Botswana 350,000
Nigeria 5.4% Ghana 350,000
Dem. Republic of Congo 4.2% Lesotho 320,000
Uganda 4.1% Angola 240,000
Angola 3.9% Swaziland 220,000
Ghana 3.1% Namibia 210,000
Madagascar 1.7% Madagascar 140,000
Seychelles* 0.2% Mauritius* 700
Mauritius** 0.1% Seychelles** <200
Sources: UNAIDS, 2004 Report on the Global AIDS Epidemic, and 2002 Report on the Global AIDS Epidemic. *As of 2002. **As of 2001. Sources: UNAIDS, 2004 Report on the Global AIDS Epidemic, and 2002 Report on the Global AIDS Epidemic. *As of 2002. **As of 2001.
• The first case of HIV in Swaziland was reported in 1986.10
• Swaziland has more than two hundred thousand people estimated to be living with HIV/AIDS (220,000 as of the end of 2003). 1
• The HIV/AIDS prevalence rate11 in Swaziland is the highest of any country in the world (38.8%), and significantly higher than that of
the sub-Saharan African region overall (7.5%) and globally (1.1%). 1
• In 2003, an estimated 17,000 Swazis died of HIV/AIDS, and life expectancy at birth in Swaziland has fallen below 40 years in large
part due to HIV/AIDS. Most deaths due to HIV/AIDS in Swaziland occur among young people.8
• HIV is spread primarily through heterosexual sex in Swaziland. 8
Populations and Regions Affected
• Women account for over half (55%) of adults estimated to be living with HIV/AIDS in Swaziland.1
• Recent studies suggest that youth in Swaziland are at significant risk for HIV infection, with young women hardest hit.8,10
Among young people ages 15-24, the estimated number of young women living with HIV/AIDS was more than twice that of young
men. Although recent studies suggest that HIV prevalence may be declining among young people ages 15-19, prevalence rates
continue to increase among those ages 20-29. 8
• In 2003, 16,000 children in Swaziland were estimated to be living with HIV/AIDS and there were an estimated 65,000 AIDS
• HIV prevalence remains high among pregnant women across the country, with the highest rates in Manzini and the lowest
Other Key Data
• Knowledge of HIV/AIDS: Studies have found that general awareness of HIV/AIDS in Swaziland is relatively high. For example,
among young women ages 15-24, 81% knew that a healthy looking person could be infected with HIV.
• Access to Antiretroviral Therapy (ART): Access to ART is limited in Swaziland. As of March 2005, an estimated 8,373 people were
receiving ART (23% of those estimated to be in need as of December 2004). 8
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International Support/Major Donors
• Several donor governments provide funding and other support to address Swaziland’s HIV/AIDS epidemic, including the United
States, the United Kingdom, Italy, and the European Union.5 The U.S. Government provides bilateral assistance to Swaziland for
its HIV/AIDS activities, although Swaziland is not one of the 15 focus countries of the United States’ President’s Emergency Plan
for AIDS Relief (PEPFAR).17 The U.S. also provides support for HIV/AIDS efforts around the world through its contributions to the
Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund).
• The Global Fund has approved two HIV/AIDS grants in Swaziland.18
• UNAIDS and the UN Family support a variety of HIV/AIDS activities in Swaziland.2,5,8
Table 1: HIV/AIDS in Swaziland1,8,13,19
Indicator Swaziland Sub-Saharan Africa Global
Estimated number of people living with HIV/AIDS, 2003 220,000 25 million 37.8 million
Percent of adult population estimated to be living with
38.8% 7.5% 1.1%
Estimated number of deaths due to HIV/AIDS, 2003 17,000 2.2 million 2.9 million
Women as percent of adults estimated to be living with
55% 57% 48%
Percent of young women, ages 15-24, estimated to be
31.6 – 47.4% 8.9% 1.4%
living with HIV/AIDS, 2001
Percent of young men, ages 15-24, estimated to be living
12.2 – 18.3% 4.4% 0.8%
with HIV/AIDS, 2001
Estimated number of AIDS orphans, 2003 65,000 12.1 million 15 million
Number of people estimated to be receiving antiretroviral 8,373 (March 500,000 970,000 (June
therapy (ART), 2005 2005 est.) (June 2005 est.) 2005 est.)
Number of people estimated to be in need of ART,
36,500 4.0 million 5.8 million
• Government of Swaziland, Ministry of Health and Welfare: www.gov.sz/home.asp?pid=61
• Swaziland National Emergency Response Council on HIV and AIDS (NERCHA): www.nercha.org.sz/
• UNAIDS Swaziland Country Page: www.unaids.org/en/geographical+area/by+country/swaziland.asp
• UNDP Swaziland: www.undp.org.sz/
• World Health Organization Swaziland Country Page: www.who.int/countries/swz/en/
• The AIDS Information and Support Centre (TASC): www.tasc.org.sz/
• Family Life Association of Swaziland (FLAS): www.flas.org.sz/
• Swaziland Network of AIDS Service Organisations (SwaNASO): www.sanaso.org.zw/country-networks.htm#swaziland
UNAIDS, 2004 Report on the Global AIDS Epidemic, July 2004.
UNAIDS Swaziland Country Page: www.unaids.org/en/geographical+area/by+country/Swaziland.asp.
Reuters, “Swaziland: More than Half of Young Adult Swazis have HIV: Survey”, April 6, 2005. http://www.aegis.com/news/ads/2005/AD050656.html.
UN Integrated Regional Information Networks (IRIN), “Swaziland: HIV Prevalence Rate among Pregnant Women Rises”, April 5, 2005. http://www.aegis.com/news/irin/2005/IR050419.html.
UNAIDS, UNAIDS at Country Level: Progress Report, 2004.
USAID, “Health Profile: Swaziland HIV/AIDS”, April 2005.
World Bank, “Country Classification: Country Groups”: http://www.worldbank.org/data/countryclass/classgroups.htm.
WHO, “Summary Country Profile for HIV/AIDS Treatment Scale-Up: Swaziland”, June 2005.
National Emergency Response Council on HIV and AIDS (NERCHA), Annual Report for the Year Ended 31st March 2004”, http://www.nercha.org.sz/AR2004.pdf.
Kingdom of Swaziland, Ministry of Health & Social Welfare, 8thHIV Sentinel Serosurveillance Report, December 2002.
Among adults ages 15-49.
UNAIDS, “Africa Fact Sheet”, March 2005.
UNAIDS, Youth and HIV/AIDS: Opportunity in Crisis, 2002.
Under age 15.
Ages 0-17, living in 2003.
UNAIDS/WHO, “Swaziland: Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Infections – 2004 Update”: http://www.unaids.org/html/pub/publications/fact-
U.S. Department of State, Office of the Global AIDS Coordinator: www.state.gov/s/gac.
The Global Fund: www.theglobalfund.org.
WHO, “3 by 5” Progress Report, December 2004.
Prepared by Jennifer Kates and Alyssa Wilson Leggoe of the Kaiser Family Foundation (KFF). Additional copies of this publication (#7366) are available on the Kaiser Family
Foundation’s website at www.kff.org.
The Kaiser Family Foundation is a non-profit, private operating foundation dedicated to providing information and analysis on health care issues to policymakers, the media, the
health care community, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.