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.

In 2021, MSF supported treatment and vaccinations for COVID-19.

Our activities in 2021 in Eswatini

Data and information from the International Activity Report 2021

MSF in Eswatini in 2021 In Eswatini, Médecins Sans Frontières supported treatment and vaccinations for COVID-19, while continuing to run programmes to curb the dual epidemics of HIV and tuberculosis (TB).

During the second and third COVID-19 waves, we stepped up our support to Nhlangano health centre by increasing capacity from eight to 26 beds and supplying oxygen concentrators. In response to the shortage of oxygen in the country, the Oxygen Plant Project was launched in mid-2021, aimed at improving care for COVID-19 and other oxygen-dependent medical conditions. Two plants are being installed, one in Nhlangano and the other at Hlathikhulu. 
In November, we started integrating COVID-19 vaccination campaigns into our daily medical activities, mainly targeting rural communities in Shiselweni. We also supported the Ministry of Health’s vaccination campaigns. By the end of 2021, 27.5 per cent of the population of Eswatini had been vaccinated.

As part of our effort to improve care for drug-resistant TB, we initiated a new short-course treatment study in Shiselweni and Lubombo regions. Patients enrolled in the study finish their course in just nine to 12 months, whereas previous treatments had taken up to two years. Another advantage of the new course is that it uses only oral drugs, which have less severe side effects than the older injectables. 

HIV is another focus of our activities in Eswatini. In 2021, we continued to work in the community, enabling patients to receive care nearer their homes, thus avoiding travelling long distances and exposure to COVID-19.  Patients can pick up their antiretroviral drug refills and access other HIV services, such as testing and chronic care, at these community delivery points. This approach strengthens adherence to treatment as it makes seeking care easier and more affordable. 

From September, we also continued to improve care for patients with non-communicable diseases, such as hypertension, in the clinics that we support. 

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Eswatini: Responding to COVID-19 in a country already fighting a dual HIV/TB epidemic

Interview 8 May 2020
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Report 27 Nov 2019
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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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