Action against HIV/AIDS in Southern African prisons

Project completed
In the countries of Southern Africa it is estimated that between 50% and 75% of prison inmates are infected with HIV/AIDS and tuberculosis. © UNODC ©

Faced with an alarming prevalence of HIV/AIDS in Southern African prisons, the SDC has undertaken to reform the prison healthcare system in Malawi, Swaziland, Zambia and Zimbabwe. Help is being provided to the relevant authorities in the implementation of set standards of care. The prison staff are being trained. Funding is also being provided for new infrastructure projects targeted specifically at women and young prisoners.

Country/region Topic Period Budget
Southern African Development Community (SADC)
Sexually transmitted diseases incl. HIV/AIDS
Reproductive health & rights
Infectious desease
01.08.2015 - 30.09.2018
CHF 3'734'300

Southern African countries have always had the highest global prevalence of HIV/AIDS. The area covered by the Southern African Development Community (SADC), made up of fifteen countries, accounts for 3% of the world’s population yet 20% of HIV/AIDS patients worldwide.

These figures are all the more alarming given the prison situation in this part of the world where prison overcrowding is widespread with an occupancy level of 138%, and where 205 out of 100,000 inhabitants are incarcerated (compared with 82/100,000 in Switzerland).

In addition to the lack of adequate health facilities and the shortage of condoms for inmates, promiscuity means that 50–75% of prisoners are thought to have HIV/AIDS and tuberculosis. Furthermore, the prisoners’ very limited access to healthcare and basic necessities implies that all too often HIV-positive patients fail to receive the correct antiretroviral treatment, exacerbating the risk of them infecting others.

Minimum standards adopted

In 2012, the national authorities in the SADC member states responded by adopting a series of minimum standards to safeguard the health of inmates in their countries. Unfortunately, these standards are rarely enforced. The SDC identified here another opportunity to share its expertise in HIV/AIDS-related public policy, an area in which it has been active in Southern Africa since 2002.

The work the SDC is supporting in prisons is critical considering the at-risk population group it serves. It receives welcome co-funding from two other organisations, Voluntary Service Overseas and the United Nations Office on Drugs and Crime (UNODC). The three agencies work together at four main levels:

  • Regional – regular meetings are organised with authorities in SADC countries to ensure that the urgent need to respect the human rights of prisoners is ingrained in people’s minds and practices.

  • National – in Malawi, Swaziland, Zambia and Zimbabwe, the project helps the Ministries (Interior and Health) involved in tackling sexually transmitted diseases in prisons to adapt various pieces of legislation and regulations.

  • In the field – training is offered to prison staff, to government officials in the prison sector and to several civil society organisations working with prisoners on the challenges presented by HIV/AIDS, prisoners’ rights and the care to be provided.

  • The remainder of the project’s budget is allocated to building or renovating the infrastructure in prisons: screening centres for HIV/AIDS and other sexually transmitted diseases, sanitation, areas designated for women and children, prison farms, etc. Initially, 26 prisons in Malawi, Swaziland, Zambia and Zimbabwe with some 70,000 prisoners will benefit from these improvements.

Women targeted

Strong concerns for the SDC and its partners in all their activities are the health and rights of female prisoners. An analysis of the situation indeed reveals that female inmates, who account for less than 3% of the total prison population in Southern African countries, regularly endure violations of their privacy. To receive a minimum level of comfort or food, some will even turn to prostitution, while others fall victim to rape perpetrated by fellow prisoners or guards.

Juvenile prisoners are another minority requiring special protection in overcrowded prisons. As part of the project, the SDC and its partners are working with the relevant authorities to transfer the youngest inmates to specialised detention centres.