The recent announcement by a local chief that he is living with HIV has brought the conservative world of traditional Swazi leadership into the thrust of 21st century AIDS mitigation efforts.
Joel Sacelo, 75, a long-serving headman in the southern Shiselweni region, who is also the pastor of a church in this impoverished rural area, chose a meeting of his fellow traditional leaders to make his declaration.
"I am HIV positive. Today I felt it was the right time to tell the world about my status," said Sacelo. The Ministry of Health is organizing meetings throughout the country to enlist chiefs and other local leaders in an effort to expand antiretroviral therapy (ART).
Swaziland has the world's highest HIV prevalence rate. In most chiefdoms, weekends have largely been reserved for funerals. If the deceased has died of an AIDS-related illness, the cause of death is often not acknowledged because of the stigma attached to AIDS.
But the extent of the mortality has made it harder to deny its cause, and leaders like Sacelo have been moved to declare their HIV status.
"I know many of you will be surprised today to learn that I am HIV positive, but it comes from my heart to disclose my status because I want the Swazis out there to know that taking ARVs does not mean you are going to die,” he told his fellow traditional leaders.
“This is the first time I have publicly declared that I am on ART, and it has been two years since I began. I want people to know that HIV-positive people are also human, like any other person."
About 70 percent of Swaziland's population live on communal Swazi nation land administered by hereditary chiefs. The country is divided into around 350 chiefdoms and most people are listed as the subject of a chief.
In an interview with IRIN/PlusNews, the widowed headman and pastor said his children and grandchildren were aware of his HIV status, as were the members of his congregation, and he had chosen to speak out to encourage others to be tested and learn their HIV status.
In a concession to modernity, the position he holds is now earned by winning a local election. Despite his age, Sacelo said he planned to run for another term as the area headman.
"We are proud of him,” Minister of Health Benedict Xaba told the meeting. “He is a role model. He has just turned 75 and this shows that to achieve a long life, people should take ARVs like… Sacelo.”
Chief Malambule Mdluli said the country's AIDS crisis has changed the way chiefs interact with their subjects - they can no longer be seen as "untouchable" and unapproachable figures, but must be pro-active on health issues to ensure the survival of their constituents.
Some senior chiefs also joined parliamentary officials at a conference in the capital, Mbabane, convened by the Swaziland Network of People Living with HIV and AIDS (SWANEPHA) to discuss the nationwide implementation of ART.
The meeting concluded with chiefs pledging to assign fields in their areas to be cultivated for food that will be distributed to local families of people living with HIV and AIDS.
"The chiefs have been educated in the need for proper nutrition for people taking ARVs. It is part of the ART roll-out into rural areas. Medication isn't enough, because for these medications to work, HIV-positive people need good food every day,” Vusi Khumalo, an AIDS activist and SWANEPHA official, told IRIN/PlusNews.
“There is only so much that these poor chiefdoms can do, but providing land to meet the needs of people living with HIV and AIDS is important for practical reasons - the food is necessary - but also for morale," Khumalo said.
"It is important that chiefs be seen as involved in AIDS efforts. Swaziland is a traditional country and chiefs hold real power - they are looked up to in their communities."