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Eswatini (formerly Swaziland)

The side effects of TB medication can induce deafness. Here, a patient has a hearing test in the MSF-built TB ward at Nhlangano health centre, Eswatini.   [© Fanny Hostettler/MSF]

No. staff in 2019: 157 | Expenditure in 2019: €3.8 million | Year MSF first worked in the country: 2007 |

Key medical figures

  • 6,900 people on first-line ARV treatment and 230 on second-line ARV treatment
  • 260 people started on treatment for TB, including 36 for DR-TB

In Eswatini, we are supporting the Ministry of Heath to curb the dual epidemic of HIV and tuberculosis (TB), which, although showing signs of stabilising, remains one of the worst globally.

Around one-third of adults in Eswatini are currently living with HIV, and many of them are co-infected with other diseases, such as TB. Médecins Sans Frontières (MSF) continues to look at ways to reduce the incidence and transmission of the diseases and improve patient care.

In 2019, our focus was to ensure that effective, innovative and sustainable HIV/TB prevention, diagnosis and treatment interventions were available to vulnerable people in Shiselweni region. 

The first new initiatives were the introduction of postnatal clubs for mothers and their babies, as well as clubs for youths and teens, and the establishment of health posts in remote communities. We also piloted the timely diagnosis of Acute HIV Infection (AHI), the first stage of HIV, which is not detected with routine testing, to prevent the early spread of the disease. Approximately four per cent of patients who came for outpatient consultations with symptoms suggestive of HIV infection presented with AHI and initiated HIV treatment.

Our teams also improved interventions at general healthcare and at community level, for example making pre-exposure prophylaxis more easily available for people at high risk of HIV infection and training community health workers and traditional healers to distribute HIV self-testing kits. In addition, we began preparations to integrate care for non-communicable diseases (hypertension and diabetes) into 10 ‘one-stop shop’ HIV/TB general healthcare clinics.

We continued to work on improving drug-resistant TB diagnosis and care, including preparing for the implementation of oral-only shorter course treatment regimens (9-12 months). Advocating better treatment options for patients with advanced HIV remained a cornerstone of our work.

Finally, the cervical cancer screening programme and the viral load/TB laboratory were handed over to the Ministry of Health.

COVID-19 Coronavirus

Most of the world's countries have reported cases of coronavirus disease COVID-19 and MSF teams in over 70 countries are now racing to respond to the pandemic.  

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