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Media Centre  |  Miscellaneous

Mswati’s HIV-Aids idiocy highlights our bitter struggle

26 February 2015

Swaziland’s absolute ruler, [i]Mswati III, adds a grotesque twist to Marx’s observation that history repeats itself, first as tragedy and then as farce.

Mswati and his regime manage to combine both qualities in equal measure: the tragedy of autocracy imposing poverty, disease and degradation on an oppressed population; the farce of the bumbling Mswati’s vanity construction projects, deluded self-image of omnipotent divinity, grasping greed.

The latest demonstration of this tragi-comic narrative is Mswati’s declaration that he would “personally” eradicate HIV-Aids from Swaziland by 2022, a deadline he has already set for the country attaining ‘first world’ status.

Swaziland is now classified as a lower-middle income country, ranking 141 out of 187 on the Human Development Index. The richest 20% of the population own and control practically all the country’s wealth.

The IMF – hardly a progressive social policy advocate – has long observed in its country reports on Swaziland that spending on the royal family drains the economy, and that there is a need for more social spending (health, education) to nurture the economy.

There are for now no high-income economies in Africa, by World Bank measurements, so Mswati’s bombastic first-world status pledge looks both ridiculous and cruel. Farce and tragedy.

Swaziland’s economic prospects are hampered by many things, but the main one in terms of our people’s capacity is the HIV-Aids pandemic. Some 26.5%, or about 290,000 of our population have the virus, the highest rate in the world.

But the 26.5% figure is an average for a total 1.1 million of our people. The prevalence of HIV-Aids among 19-24 year-olds in Swaziland was 40.8% in 2010.More than 80% of people with HIV-Aids also have TB.

Anti-retroviral treatment is reckoned to reach 85% with advanced HIV infection. But many thousands do not receive treatment at all.

And this 85% figure is too neat. It is the regime’s figure for how well it is doing. It doesn’t take into account zigzags in the availability of ARVs, the numbers of people who fatefully drop out of the treatment programme, the effects of inadequate counselling, the numbers who go to South Africa to receive treatment.
Mswati’s nonchalant pledge on eliminating HIV-Aids in our country over the next seven years is meaningless.

Last year, 2014, the regime pledged to cut mother-to-child-transmission, or PMTCT, of HIV by 95% by this year, 2015. This would have required a great acceleration of earlier ostensible PMTCT commitments and stands as an empty Mswati promise.

The same goes for his 2022 HIV-Aids eradication deadline. And here’s why.

One reason – the farce – is that Mswati either thinks that none of our people who have HIV-Aids will be alive after seven years, or that there will be a universal cure by that date and so everyone will be fine. Assuming that treatment is properly available, the hundred thousand or so people on ARV treatment will, we hope, still be with us after 2022, and they will still need treatment and care. Mswati’s cut-off date is as nonsensical as is his rich country-status fantasy.

The real reason – the tragedy – runs deeper.

We often think that channelling all of Mswati’s ill-gotten cash to public needs would solve our problems as a potential ‘developmental state’. But at most, this would restore some balance and fairness to the state budgeting and fiscal process. And it would unleash a steady flow of much needed moola into the treasury. But it would not solve all our problems, not least in combating HIV-Aids.

If all the money that was wasted on the monarchy, all the funds wrongly diverted to the bank accounts of the king, his wives and children, and his extended family; if all the revenue from land and resources held by the kind “in trust for the Swazi nation”; if all the Swazi money held by the king in foreign tax havens and secret bank accounts – if all that was put where it belongs, into the Swazi economy under a system of democratic representation and accountability. Then at most we might be in a better position to take charge of most of the spending on anti-retroviral treatment (ART), which currently is some 60% dependent on foreign donors.

We might also be able to cut costs of treatment by opting for WHO-recommended first and second line combinations. Currently, treatment expenditure in Swaziland works out at about $509 per person per year for the roughly 110 000 people on ARVs. It should be much less, as little as $172 per person per year for first-line single pill combinations, and about $303 for second-line treatment.

According to Forbes, in 2008 Mswati was worth $200 million (now E2.3 billion). ARV treatment costs from national and international sources runs to about E6.2 billion ($56 million) a year.

Mswati’s savings would not cover this for long. But if we were to channel the E550 million ($50 million) Mswati counts as personal income, according to Forbes, and if we were to ensure that Swaziland followed the WHO recommendations on affordable treatment regimes, we would be able to severely dent treatment expenditure. And this only concerns pharmaceutical treatment costs. It doesn’t touch on the costs of the rest of the work to tackle HIV-Aids, all of which needs overhauling and improving.

The point is that our HIV-Aids pandemic is a massive battle. It is one that demands vast resources and strategizing that will take years to enact so we can gradually reduce the incidence and burden of the disease. As the CPS, we do not trust the Mswati regime’s pledges of solving this or that facet of the crisis by any particular date.

We have seen the regime’s budgetary deceptions all too often in the past to trust that the information it provided – especially the statistics and projections – for the Swaziland Global Response Progress Reporting 2014 (UNAIDS).

The regime plays fast and loose with revenue and donated cash. We have every reason to doubt its rosy descriptions of what it is achieving in combating HIV-Aids. Our emergence from the pandemic requires emergency action geared to wholly scientific and candid approaches, and much of this is impossible as long as the autocracy remains in power.

Mswati’s asinine remarks on ending the pandemic in seven years comically unmask a hard reality that we are still very far from beating.

By CPS

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