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Health promotion, community outreach


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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.

Our activities in 2022 in Eswatini

Data and information from the International Activity Report 2022

MSF in Eswatini in 2022 Médecins Sans Frontières (MSF) has been working in Eswatini’s Shiselweni region for 15 years, responding to a variety of health issues, including HIV and tuberculosis (TB), and, since 2020, COVID-19.
Eswatini IAR Map 2022

In 2022, during the fourth COVID-19 wave, we provided home-based support, enabling patients to receive treatment for the virus without having to travel long distances. As well as home visits, we offered follow-up care through teleconsultations. As new infections declined from July, we switched our focus to providing vaccinations and using the two oxygen plants we installed in Hlathikhulu and Nhlangano in 2021 to improve care for patients with COVID-19 and other oxygen-dependent conditions.

As part of our patient-centred approach, we continued to run innovative, digitally-supported programmes that guarantee quality of care, such as video-observed therapy for drug-resistant TB, whereby a health worker remotely watches a patient take their medication. We also introduced  ‘The Pocket Clinic’ project, which offers counselling sessions pre- and post-HIV testing through smart devices. These types of innovations strengthen adherence to treatment, as they make seeking care easier and more affordable.

To curb the spread of HIV in Eswatini, which has the highest prevalence of the disease in the world, MSF offered health education and access to preventive measures, such as condoms and pre-exposure prophylaxis, to people who tested negative.

We also initiated a study to examine the burden of sexually transmitted infections (STIs) and the feasibility of providing STI care in the community in Eswatini. The study assessed the prevalence of asymptomatic and symptomatic STIs and involved continuous engagement with participants through interviews. The results will be disseminated at the end of 2023.

To address the rise in non-communicable diseases, a pilot programme was implemented for fixed-dose combinations of two drugs in a single pill for hypertension treatment.

We have also been implementing environmentally-friendly measures to minimise MSF’s carbon footprint, using solar panels to generate electricity in a remote clinic in Gege, and using hybrid energy vehicles for transport where possible. 


In 2022
TB support in Swaziland

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

Statement 25 Jun 2018
TB support in Swaziland

"A long and gruelling seven years and now it is over"

Voices from the Field 29 Jun 2017
Sign language training and TB support in Swaziland

For patients with XDR-TB, treatment is a gruelling journey with severe side effects

Voices from the Field 27 Feb 2017
Bending the Curves - Eshowe HIV

MSF calls for quality HIV care in neglected communities

Press Release 18 Jul 2016
MSF HIV Testing Clinic's in Conakry

7 things you may believe about HIV/AIDS that turn out to be wrong

Project Update 19 Apr 2016
Swaziland - Figthing HIV and TB dual epidemic

Countries should take up new WHO ‘test and treat’ guidelines

Press Release 24 Nov 2015

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