According to the World Health Organisation, 37.9 million people worldwide are currently living with HIV or AIDS (2018 figures) and 210,000 of them live in the Kingdom of Eswatini. With an official infection rate of 41.1 % (2016) among pregnant women and 27.3% (2018) among all those aged 15-59 years, Eswatini has the highest rate of HIV in the world. (HIV+ve rates for men: 18% women: 35%). The epidemic has overburdened the country's health system, crippled its economy, created a shortage of teachers in all levels of education and thwarted all aspects of the Kingdom's development. It is estimated that 59% of the population live below the poverty line, with an estimated 37% in extreme poverty. In Eswatini, everyone, positive or negative, has been hurt by HIV/AIDS. Average life expectancy is estimated at 58 years.

Unfortunately, Eswatini's children are no exception. By 2018, an estimated 43,000 children in the Kingdom were orphaned due to AIDS, with a disproportionate number of these orphans living in the Shiselweni region.

Avert (See Avert website for details) reports: During the last decade, Eswatini has made significant progress in controlling its HIV epidemic. HIV prevalence is stabilising and the number of new infections among adults has declined by around a third (31%) since 2010, largely due to rapidly scaling up the number of people accessing antiretroviral treatment (ART). With 86% of all people living with HIV on ART, the country has one of the highest treatment coverage rates in sub-Saharan Africa. Of those people living with HIV and on treatment, 94% are virally suppressed. Nevertheless, HIV is still the country’s biggest public health concern.  

The numbers are devastating but what does it really mean? Before the scourge of HIV/AIDS, orphaned children would be cared for by uncles, aunts or grandparents, but now even the extended family is suffering from HIV. In the Shiselweni region, over half of all homesteads are currently caring for at least one orphan of AIDS, but this situation is neither ideal nor permanent. Many homesteads lack the food or other resources to care for these additional children,  particularly if the orphans are also sick with HIV. Many cannot afford to send these orphans to school. Even worse, many children are shuffled from one homestead to the next as their aunt, uncle, grandmother or neighbour also dies of AIDS, eventually leaving them with nowhere to turn. Child headed households are on the increase as children lose their parents to HIV/AIDS. These children are particularly vulnerable to abuse and exploitation.

Since it first opened its doors in 2003, Pasture Valley Children's Home has provided a permanent, loving home for a small number of Eswatini's orphaned and vulnerable children. While this does little to improve the overall situation in the Kingdom, the Children's Home has given these children a healthier, more certain future.