Five key facts about MSF’s medical operations in Eswatini:

Improving access to services

When MSF teams arrived in the Shiselweni region in 2007, only three hospitals offered treatment for these diseases. Now, clinics throughout the region are equipped to provide patients with the care they need. In addition to the increased access to treatment, people have gained knowledge about HIV and TB infections. Previously the diseases were surrounded by harmful myths, but now people have access to accurate information on how to prevent and manage them.

Working with communities

To reduce the number of people contracting and potentially dying from HIV, TB, and other related conditions, we consulted communities and, in urban areas, our community health workers distributed HIV self-testing kits. This project was supported by the National Emergency Response Council on HIV/AIDS and helped us achieve the UNAIDS target of getting 95% of people to know their HIV status.

Testing new ideas

Self-testing was not the only innovative approach we piloted. MSF introduced Early Access to Antiretroviral Therapy for All (EAAA), a programme to ensure that when people test positive for HIV, they can start treatment the same day or as early as possible.

For people with drug-resistant TB, who have traditionally faced long and complex treatment programmes, our team piloted an all-oral short course, in which patients completed treatment more quickly and without the need for painful injections, with new medications.

Reducing the burden of treatment

The team was keen to further reduce barriers to treatment after seeing the impact of moving our services to primary healthcare centres. We piloted community ART groups, where HIV patients living in rural communities take turns collecting the medications for the whole group, thus reducing the number of long journeys patients must take and the likelihood that people will drop out of treatment.

Adapting to a new crisis

In March 2020, following the declaration of the COVID-19 emergency, we established a team of doctors and nurses to follow up on COVID-19 cases at the community level, and a specialist ward to increase the amount of in-patient care available. MSF also constructed two oxygen plants in the region, which remain a game-changer not only for treating COVID-19 but for any patients who need medical oxygen, including people with TB.