The African State and the AIDS Crisis by Amy S. Patterson

Author:Amy S. Patterson [Patterson, Amy S.]
Language: eng
Format: epub
Tags: Health & Fitness, Diseases, Aids & Hiv, Political Science, International Relations, General
ISBN: 9780754639671
Google: r_0AwQEACAAJ
Goodreads: 753111
Publisher: Ashgate
Published: 2005-01-15T06:15:36+00:00

The AIDS Epidemic and the State in Swaziland

The particular nature of the Swazi state has contributed to the spread of HIV and has resulted in the country having the worst epidemic in the world in 2004. In its national development policies, the state has emphasized inward investment and has sustained an economic structure that has contributed to high levels of labor migration. In an attempt to compete in the global market, the Swazi government has promoted neoliberal policies, including low wages and limited protection of workers' rights. The worker mobility and economic inequality that have resulted from these strategies have created a climate in which HIV has spread easily. Additionally, the nature of the political system has made it difficult for the state to respond to economic and social crises, such as unemployment, inequality, and HIV/AIDS. The state lacks accountability to civil society groups such as opposition parties and trade unions. The lack of political freedom, the limited state transparency in decision making, and the relative isolation of political elites from citizens have hampered the policy-making process. The political system, with its emphasis on male-dominated power structures, polygamy in the royal family, and minimal rights for women, amplifies the gender inequality that contributes to the spread of HIV. Indeed, the most vulnerable group in Swaziland is out-of-school youth, especially young women. These women are probably the core transmitter group for the virus. However, because these women are exploited by society at large, and by older men in particular, it is inevitable that they will transmit HIV to others.

In addition, the lack of capacity of the Swazi state hampers its ability to address HIV/AIDS. Corruption and nepotism, as well as modern and traditional institutions that coexist in tension, complicate state actions on HIV/AIDS. The AIDS epidemic itself has diminished state capacity and the ability of the state to effectively serve its citizens. This pattern is becoming more apparent in the realms of health care, education, and public safety. In 1998, the Ministry of Health studied HIV prevalence rates among patients in selected hospitals. The resulting data showed that 49.5 per cent of patients were HIV positive, with 52.8 per cent being female and 45.6 per cent being male. The highest numbers of AIDS patients were between 20 and 39 years old (Government of Swaziland 1998). It is believed that since the study, HIV-positive patients occupy a greater number of hospital beds, and this burden on the public sector continues to increase. A study of bereavement notices in the Times of Swaziland from 1 July 1994 to 30 June 1999 revealed that the total number of deaths in Swaziland rose substantially during this period. The majority of individuals who died were between 26 and 40 years old (Whiteside et al. 2002a). A 2001 assessment of the impact of HIV/AIDS on the Ministry of Economic Planning and Development, the Ministry of Finance, and the Ministry of Public Service and Information estimated that AIDS will negatively impact personnel and ministry resources. To simply maintain current staff levels, 1.

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