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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
Bangladeshis without borders, communication package 4 sept 2014

Bangladesh Without Borders: Reducing the burden of HIV and tuberculosis in Swaziland

Voices from the Field 4 Sep 2014

Surviving drug-resistant TB: “I’m still over the moon”

Project Update 24 Jul 2014
Swaziland - Figthing HIV and TB dual epidemic

Treating HIV and TB in Swaziland: “We didn’t know what to expect”

Voices from the Field 30 Jun 2014
Journal article

Impact and programmatic implications of routine viral load monitoring in Swaziland

28 May 2014
Journal article
Swaziland - Born HIV-free

Born HIV-free

Report 17 Sep 2013
Swaziland - Born HIV-free

MSF rolls out innovative medical approach to prevent mother-to-child HIV/AIDS transmission

Project Update 17 Sep 2013

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