Activities 2015 International Activity Report
Swaziland is struggling to cope with the dual epidemic of TB and HIV. It has the world’s highest incidence of TB, and the number of people with drug-resistant forms of the disease (DR-TB) is increasing. Furthermore, around 80 per cent are co-infected with HIV. Since 2007, MSF has been collaborating with the Ministry of Health to tackle this crisis.
Responding to the growing number of extensively drug-resistant TB (XDR-TB) cases in the country, MSF advocated the introduction of new drugs (bedaquiline and delamanid) in 2014. In 2015, staff started treating XDR-TB patients with these in combination with repurposed drugs – a major change for these patients. By the end of the year, 22 XDR-TB patients were on this treatment programme in MSF projects in Manzini and Shiselweni.
MSF teams in Shiselweni continued to support the integration of HIV and TB care in 22 community-based health clinics. As part of this support, MSF has been operating 20 point-of-care mini-labs since 2012. In 2015, these labs carried out 47,842 biochemistry tests, 19,340 CD4 tests and 30,726 viral load tests – the latter of which measure the amount of HIV in a sample of blood and are the strongest predictor of HIV progression. To improve adherence to treatment, MSF has trained people living with HIV as ‘expert clients’ or lay counsellors to work with patients.
This year, to bring services closer to home, MSF piloted multiple community outreach models, including community antiretroviral (ARV) treatment groups and clubs and new ways of delivering medication to patients. Following the positive outcomes in the Shiselweni pilot, these models will now be implemented as a national strategy.
Year MSF first worked in the country: 2007.
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