Description

This comprehensive research study is one of the first to scientifically review HIV/AIDS policy, legislation, financing and programme implementation in the six selected southern African countries of Botswana, Lesotho, Mozambique, South Africa, Swaziland and Zimbabwe.

Prior to this report, little scientific documentation existed. This study not only reviews the HIV/AIDS policy and related issues but also provides recommendations on how best to strengthen policy in these six southern African countries.

The report was commissioned by the Centre for Applied Social Studies (CASS), through the W K Kellogg Foundation, with an underlying theme to assess to what extent each of the heavily affected southern African countries has met the UN goal of developing multisectoral, national strategic plans by which to address the HIV/AIDS epidemic.

The report is based upon national reviews of current policies, strategic plans and actual programs on HIV/AIDS, as well as key informant interviews conducted with staff of governmental departs, NGOs, People Living With HIV/AIDS (PLWHA), inter alia. Detailed analysis of in-country drug policies
in relation to the prevention and treatment of the disease was analysed, as well as the level of treatment infrastructure. There was a review of documentation from state financial institutions, of national legislation
affecting infected persons, and of information elicited at workshops with key informants from Kellogg sites.

The result of the research demonstrates the level of commitment across the region, the mechanisms in place and the constraints in the implementation of HIV/AIDS policies, strategies and programs in southern Africa.

Contents
List of tables
Abbreviations
Contributors

Executive summary

Research context

The research
Rationale for this study
Objectives of the study
The problem of HIV/AIDS in selected SADC countries
Botswana
Lesotho
Mozambique
South Africa
Zimbabwe
Swaziland
Factors fuelling the epidemic in the SADC region

Methodology
Generic research instruments
Policy review
Review of implementation of HIV/AIDS programmes
Legislation review
Ethics of conducting the study
Approval for the study from government
Methodology: country specific
Botswana
Lesotho
Mozambique
South Africa
Swaziland
Zimbabwe

HIV/AIDS national policies and legislation
Rationale for policies
HIV/AIDS policy and strategic plans
Botswana
Lesotho
Mozambique
South Africa
Swaziland
Zimbabwe
Summary
General conclusions on the policy aspects
Recommendations

Implementation: Guidelines, barriers and proposed solutions
Guidelines: voluntary counselling and testing (VCT)
Guidelines: prevention of mother-to-child transmission of HIV (PMTCT)
Guidelines: treatment of opportunistic infections
Guidelines: infant feeding of HIV positive mothers
Guidelines: nutrition for people living with HIV/AIDS
Existence of guiding documents
Existence of policies on orphans and rape
Existence of ministerial policies
Barriers to implementation of HIV/AIDS policies and strategic plans
Botswana
Lesotho
Mozambique and Swaziland
South Africa
Zimbabwe
Recommendations for addressing barriers to implementation of HIV/AIDS policy and plans

HIV/AIDS drug policy
Background
Level of development of national drug policies for six SADC countries
Patent laws and their effect on drug policies for HIV/AIDS and availability of drugs
Methods that can be used to circumvent the patent protection obstacles
Parallel importation
Voluntary license
Compulsory license
Civil disobedience
Conclusion

Services and programmes
Botswana
Lesotho
Mozambique
Swaziland
South Africa
Summary

Findings of the legislation review
Botswana
Lesotho
Mozambique
South Africa
Swaziland
Zimbabwe
Conclusion
Recommendations
Gender and HIV/AIDS
General conclusions on the legislative aspects
Recommendations on legislative aspects

Summary, conclusions and recommendations
Legislative aspect
Overall recommendations
General barriers to implementation of policy

Appendices

References and documents reviewed