Health promotion, community outreach


Eswatini (formerly Swaziland) has one of the world’s highest rates of HIV, with nearly one in three adults living with the disease. However, around 80 per cent of people with TB in Eswatini are HIV positive.

Estimates suggest that HIV incidence rates in Eswatini have fallen in recent years, as significant progress has been made in improving the number of people receiving antiretroviral (ARV) treatment.

We continue to help more HIV patients access ARV treatment through the ’test and start’ strategy. A team has been piloting ‘test and start’ in the Nhlangano project; after HIV testing, ARV treatment was offered to more than 1,700 people after a positive HIV diagnosis to immediately start treatment.

We now treat patients with extensively drug-resistant TB (XDR-TB), and those developing severe side effects, using the promising new drugs bedaquiline and delamanid in combination with repurposed drugs.

MSF teams are currently responding to the coronavirus COVID-19 pandemic in Eswatini.

Our activities in 2020 in Eswatini

Data and information from the International Activity Report 2020

MSF in Eswatini in 2020 In Eswatini, the COVID-19 pandemic severely affected the lives of patients with HIV, tuberculosis (TB) and non-communicable diseases (NCDs) in 2020.
Map of MSF activities in 2020 in Eswatini

Around one-third of adults in Eswatini are currently living with HIV, and many of them are co-infected with TB. Médecins Sans Frontières (MSF) supports the Ministry of Health by working on reducing the transmission of these diseases and improving treatment.

The pandemic forced our teams in the Shiselweni region to change how care was delivered, to ensure that the most vulnerable people had uninterrupted safe access to lifesaving treatment.

We strengthened community-based drug-resistant TB (DR-TB) care, with health workers visiting patients’ homes to give them medication, food, psychological support and COVID-19 preventive equipment (masks, sanitisers). Video-observed treatment allowed these patients to film themselves taking their medication at home, instead of travelling to health facilities for nurse-observed treatment. In addition, we increased our support to the national DR-TB ward in Shiselweni, by providing nursing care, implementing COVID-19 prevention and detection protocols, and donating medicines.

To relieve pressure on health facilities as COVID-19 cases surged, we set up mobile clinics and a health post to offer care for TB, HIV and NCDs such as hypertension and diabetes. Our services included testing, screening, medication refills and advice on COVID-19 prevention.

We also incorporated care for NCDs into general healthcare facilities, and increased the services offered at our community site in Nhlangano to cover HIV self-testing, pre-exposure prophylaxis to prevent HIV infection, family planning, and treatment for HIV and sexually transmitted infections. In 2020, we completed a study looking at diagnosing and treating HIV earlier during the window period – the time between infection and the point when a test gives an accurate result. This will guide our future work on HIV epidemic control.

Other COVID-19 activities included supporting the health authorities to increase testing capacity, and sending an MSF community team to provide home-based care and refer critically ill patients for oxygen therapy.


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Video Observed Therapy (VOT) training for MDR-TB patients in Matsanjeni health centre
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Eswatini: Responding to COVID-19 in a country already fighting a dual HIV/TB epidemic

Interview 8 May 2020
Malawi - Advanced HIV

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Press Release 1 Dec 2019
Malawi - Advanced HIV

MSF report "No time to lose" examines the fight against AIDS in 15 countries

Report 27 Nov 2019
TB support in Swaziland

MSF hands over its Manzini project, while continuing activities in Shiselweni

Statement 25 Jun 2018
TB support in Swaziland

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Voices from the Field 29 Jun 2017

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