The HIV/AIDS Epidemic
HIV prevalence in Zambia is 14.3%. Vulnerable populations include female sex workers, MSM, prisoners, and STI and TB patients, though HIV prevalence among vulnerable groups has not been systematically monitored. However, HIV incidence in adults has stabilized at 1.6% (2% in women, 1.2% in men). Urban adult HIV prevalence at 19.7% is almost twice that of the rural areas, 10.3%, and adults with higher education are more at risk of HIV infection compared to those with little or no education. The HIV prevalence in prisons, 27%, is almost double that of the general adult population; condoms are banned from prisons.
In its 2010 Country Report to UNGASS, Zambia's National AIDS Council (NAC) recognized that "for each affected household and person, HIV brings economic pressures and disadvantages that tend to increase poverty." Mobile populations and prisoners have been targeted for prevention programs along with other vulnerable groups. Documented barriers to accessing antiretroviral treatment and medical care include the costs of transportation, food and accommodation, as well as the replacement cost of work and care-giving.
The Housing Crisis
Zambia is one of the most urbanized countries of sub-Saharan Africa, second only to South Africa, with 40% of the population living in urban areas. Approximately 74% of the urban population lives in slum conditions, while on the human development index Zambia ranks 164th among 182 countries, or in the lowest 10%. About 36% of the population is economically inactive; up to 87% of the population live on less than two dollars a day. The peri-urban slums are characterized by overcrowding, inadequate water supply, poor sanitation and drainage, uncollected solid waste, and inadequate security of tenure.
The majority of Zambian households are led by men, and so women depend on men for their housing security and economic livelihood. Women have little legal power to protect their assets and the security of their home when they lose their husbands to HIV/AIDS. Many widows lose their property to their in-laws upon the death of their husbands. Widows are often blamed for their husbands' death, and sometimes a widow is forced to into sexual relations with her brother-in-law as "sexual cleansing." Customary inheritance laws dictate that property and assets of the deceased be left to parents and siblings, leaving widows at a disadvantage. Statutory law dictates that the assets of a man who dies without a will are divided 50% to the wife and children, 20% to his parents, 20% to his siblings and the remaining 10% to other dependants. However, this law is largely unknown, and often not respected given its contradiction with customary inheritance law.
According to a community survey carried out by the Treatment Advocacy and Literacy in Chazanga, where HIV transmission is concentrated among the poor, the main problem associated with housing in the community includes quality of affordable housing and issues with property/inheritance rights and displaced populations. HIV-positive residents in Chazanga are more vulnerable to issues of housing instability because of lack of income; many have lost employment prematurely due to poor health, while others must prioritize their savings for medical expenses.
Institutional Response & Solutions
The government of Zambia does not have a clear policy for how to deal with informal or unplanned settlements. Various attempts have been made to formalize the settlements, but progress has been slow and hampered by financial and human resource constraints at both the national and local government levels. Numerous government requirements hinder the provision of basic infrastructure and services and the granting of secure tenure to existing informal settlement occupiers.
Zambia still does not have a law protecting PLWHA from discrimination. One of the goals in the country's Strategic Framework is to provide social support for "those made vulnerable by the HIV and AIDS epidemic." Strategies to achieve this goal include: (1) Protect and provide support for OVC; (2) Provide social protection for people made vulnerable by HIV/AIDS; and (3) Promote programs of food security and income/livelihood generation for PLWHA and their care-givers and families. Approximately 15.7% of households with OVC receive external support in the form of medical care and supplies, school-related assistance, counseling, or other social support, including clothing, food, housing, and financial support.
The Bwafwano Care Project provides housing and support for elderly populations and houses with OVC. However, according to advocates the major obstacles to providing adequate shelter for PLWHA are lack of adequate resources and the stigma and discrimination associated with the pandemic. The Treatment Advocacy and Literary Campaign is calling on the Global Fund to allocate funds for housing for PLWHA in their disbursement to Zambia.
Advocate testimony provided by Harrison Mwima of the Treatment Advocacy & Literacy Campaign.
Human Rights Watch, Unjust and Unhealthy: HIV, TB, and Abuse in Zambian Prisons, 2010.
Mendenhall, E. et al, Property Grabbing and Will Writing in Lusaka, Zambia: An Examination of Wills of HIV-infected Cohabiting Couples, AIDS Care: 19(3), 369-74, 2007.
UNGASS Country Progress Report: Zambia, 2010.
UN-Habitat, Zambia Statistical Overview, 2010.
UN-Habitat, The Sustainable Cities Programme in Zambia (1994 - 2007): Addressing Challenges of Rapid Urbanization, 2009.
World Bank, Upgrading of Low Income Settlements: Zambia Country Assessment Report, 2002.