How the world’s highest HIV-prevalence country turned around, and in record time

How the world’s highest HIV-prevalence country turned around, and in record time

Share on facebook
Facebook
Share on twitter
Twitter
Share on linkedin
LinkedIn
Share on email
Email
Share on print
Print

GENEVA, Switzerland, December 03, 2020,-/African Media Agency (AMA)/-Because her government aggressively pursued treatment as prevention for people living with HIV, Thembi Dlamini and several women in her support group have been able to counsel each other, give family advice and run an artisanal business. In other words, their government gave them a life together.

Without the availability of the drugs for free, “we would have died,” she says.

It is that pivotal decision and several other critical supporting moves that have enabled Eswatini to become the first country in Africa to achieve the United Nations HIV target: 95% of people living with HIV know their status, 95% of them are on life-saving antiretroviral treatment, and 95% of those on treatment have a suppressed viral load. The country that once had the world’s highest HIV prevalence did so 10 years ahead of the 2030 goal.

After detecting the first case of HIV in 1986, the country experienced an explosion of HIV cases. Following several waves of new HIV infections and deaths, the government declared HIV a national emergency in 1997 and committed that by 2022 it must no longer be a public health threat.

Propelling concerted action

The government’s decision galvanized a multisector response, considered the foundational success factor. The National Emergency Response Council on HIV/AIDS (NERCHA) was established in 2001 to coordinate activities from government to communities, including training for traditional leaders. Housed within the Prime Minister’s Office and funded by the government, NERCHA steered the agenda and programmes towards the goal.

The government’s commitment meant providing free antiretroviral (ART) drugs for HIV patients “We were the first country to say we need to look closely at treatment,” says NERCHA Director Khanya Mabuza. In 2016, the commitment expanded to cover the provision of drugs as soon as someone tested positive.

To ensure uninterrupted treatment programmes, the government procured 80% of antiretroviral drugs, whilst international partners covered the gap, says Dr Vusi Magagula, Director of Health Services.

The government also provided laboratory technologies for CD4 and viral load monitoring. Another critical part of the strategy has been improving patients access to these monitoring and treatment services. Access improved for HIV clients through the implementation of game-changing nurse-led ART policy, where nurses were trained to initiate treatment under the mentorship of doctors from nearby hospitals, with regular oversight provided by PEPFAR partners.

The HIV services at the community primary health care clinics were linked with HIV prevention activities as well as prevention of mother to child transmission of HIV, tuberculosis and non-communicable disease services. HIV testing services are routinely provided at all health facilities, and the age of consent for HIV testing was reduced to 12 years.

Early on, in 2009, the government opted to give patients with a stable record of high adherence to their treatment three months’ refill of their medication. Recently and due to the COVID-19 pandemic, the government accelerated the plan to dispense six months’ refill supplies.

In response to the impact of COVID-19 pandemic on continuity of services, the government expanded its community service delivery to take HIV testing, prevention and treatment services (including ART drug distribution) to people through outreach programmes that rely on rural health motivators and HIV treatment adherence support initiatives.  The effect of all these initiatives helped to maintain uninterrupted regimes and to connect with key and vulnerable populations.

Other innovative community approaches common across Eswatini are peer-to-peer support for people living with HIV, mentor-mothers and community adherence treatment supporters for adolescents and young people.

Thembi Dlamini helped start one of the peer-support groups in her Mayiwane community in the northern Hhohho region, which she says includes HIV-negative members. “We do this so that those who have not tested yet can see we all live normal lives. There’s no need for discrimination,” she explains, after describing how she was shunned when she first started living with HIV. “Many people thought I had been bewitched.”

“The community mobilization and HIV communication programmes have influenced change in behaviours on stigma and discrimination and improved HIV service uptake in communities,” says Dr Nomthandazo Lukhele, the World Health Organization (WHO) HIV/TB Officer in Eswatini.

Protecting the success in the pandemic

A critical part of the drug-adherence monitoring has been keeping a close eye on drug resistance. In 2016, the Ministry of Health and PEPFAR carried out two HIV drug resistance surveys, which led to a shift to a new drug in the ART regimen, in line with WHO guidelines.

The combined gravitas of all the interventions led to a 66% decline in new HIV infections between 2010 and 2019, with AIDS-related deaths declining by 49%.

“Eswatini is a small country with a population of just over a million people. Hence, its achievement of the 95-95-95 should be an inspiration to many other countries, as we have shown that it can be done,” says Minister of Health Lizzie Nkosi in an interview.

The country is also showing how to overcome the threat to success that the COVID-19 pandemic has presented. When the lockdown led to declines in immunization, HIV and TB services, the government went into catch-up mode and continues to invest in the capacity, availability and well-being of the health workforce at all levels of the health system.

Distributed by African Media Agency (AMA) on behalf of World Health Organization.

You might also enjoy

Subscribe To Our Newsletter

Get updates and learn from the best

Conférence de Presse en Ligne


Les frontières terrestres ne doivent pas constituer des obstacles à la dissémination de votre message. Grâce à notre service de conférence de presse en ligne, nous vous offrons l’opportunité de vous rapprocher des médias africains, chaque fois que vous en aurez besoin.

Nos services comprennent:

Digital Communications


Today, social networks constitute an organization’s first point of contact with a user and a potential customer. At first glance, you need to convince of the relevance and quality of your content to stimulate and motivate the user to go further. We create consistently inspiring online strategy to meet business objectives, engage stakeholders and enhance our client brand’s reputation internally and externally.

 

Communication​ digitale


Les réseaux sociaux représentent aujourd’hui le premier point de contact d’une organisation avec un utilisateur et un client potentiel. Au premier coup d’œil, vous devez le convaincre de la pertinence et de la qualité de votre contenu pour l’inciter à aller plus loin. Nous créons pour vous une stratégie de communication précise et adaptée sur les réseaux sociaux pour atteindre les objectifs commerciaux, impliquer les parties prenantes et améliorer la réputation de votre marque en interne et en externe.

Promotion​ d’événements


Le succès d’un événement réside en moitié dans sa promotion. Peu importe la beauté de l’événement, la qualité des orateurs et de l’ordre du jour, si personne ne rapporte ou ne parle de votre événement, vos efforts seront vains. Nous vous aidons à façonner votre récit et à créer un engouement autour de votre événement. De l’annonce de l’événement à la tenue de celui-ci, nous accompagnons votre effort de planification et le reflétons sur toutes les plateformes médiatiques.​

Formation​ Médiatique


Nous fournissons à vos porte-paroles les outils nécessaires pour présenter vos principaux messages et répondre avec confiance et cohérence aux questions. Notre formation est organisée soit à distance ou en présentiel, avec des études de cas réels et des répétitions. Nos clients repartent avec le sentiment d’être à l’aise devant les journalistes et d’agir en tant qu’ambassadeurs de la marque.

Veille​ Médiatique


Nous mesurons votre portée en relations publiques et rendons compte des informations de votre industrie et des activités de vos  concurrents en surveillant la majorité des canaux de diffusion dans toute l’Afrique. Une veille médiatique complète et opportune est essentielle pour s’assurer que vous ne manquez aucune référence à votre marque, que vous êtes constamment informé de ce qui se passe dans votre industrie et que vous êtes prêt à saisir les opportunités et à réduire les risques en temps opportun.

Relations​ Média


Peu importe le lieu où ils se trouvent, nous sommes une source d‘informations fiables pour les journalistes qui écrivent sur l’Afrique. Nous nous connaissons mutuellement et ils nous font confiance, car nous leur fournissons un contenu crédible qui les aide dans leurs tâches. Nous nous entretenons quotidiennement avec des journalistes aux quatre coins du continent, ce qui fait de nous l’un des organismes les plus efficaces pour mener des campagnes de relations avec les médias.

Stratégie et développement de contenu


Nous créons des stratégies de communication intelligentes, bien documentées et spécialisées destinées à vous aider à construire un récit fort qui engagera votre audience. Nous travaillons en synergie avec vous afin de rédiger des communiqués de presse et des articles d’opinions qui alimentent le récit de votre entreprise. Notre équipe a une expérience approfondie dans la création de récits et le développement de contenu multimédia.

DIFFUSION DE COMMUNIQUES​ DE PRESSE​


C’est le service phare d’AMA. Nous avons mis en place des canaux de diffusion des communiqués de presse auprès des journalistes des 54 États africains ainsi qu’auprès des journalistes américains et européens couvrant les sujets relatifs aux marchés émergents.​

​Nos services comprennent:​

Event Promotion


Half of the success of an event lays in its promotion. Doesn’t matter how beautiful the event is, how wonderful the speakers and the agenda are, if no one reports or talks about your event, your efforts are gone. We help you shape the narrative and create a drumbeat around your event. From the announce all the way to the outcome of the event, we accompany your planning effort and echo it through all media platforms

Media Training


We provide your spokespeople with the tools to present your key messages and answer questions with confidence and coherence. Our training is organised either remotely or face-to- face, with real case studies and rehearsals. Our clients leave feeling comfortable being in front of reporters and acting as brand ambassadors.

Media Monitoring


We measure and report on
your PR reach, industry news, and competitive activity by monitoring most channels in North, West, Central, East and Southern Africa. Comprehensive and timely media monitoring is critical to ensuring that you don’t miss any reporting of your brand,
you’re constantly informed on what’s going on around your business, and you’re ready to capitalise on opportunities and mitigate
risks in a timely fashion..

Media Relations


We have become an authoritative source of news for reporters writing about Africa, wherever they are. We know them, they know us, and they trust us for providing them with timely and accurate content that helps them do their job. We speak to reporters on a daily basis in all corners of the continent and this makes us one of the most effective agencies in running media relations campaigns.

Strategy & Content Development


We create smart and localised communications strategies to help build a strong narrative that will engage your audiences. We partner with you to create press releases and thought leadership pieces that sustain a drumbeat for your company’s narrative. Our team have deep experience in shaping narratives and developing media content.

PRESS RELEASE WIRE DISTRIBUTION

This is AMA’s flagship service. We have set up channels of distribution towards the journalists of the 54 African states, as well as to American journalists and European journalists covering emerging markets issues.
Our service includes:

Editorial advice

Localised editorial piece when needed

Distribution to the major print, broadcast and online publications along with industry-specific publications

Follow-up calls to secure interview request

Guaranteed distribution to Africa.com

Distribution to Bloomberg, LexisNexis and Thomson Reuters

Social Media Reach: Facebook, Twitter, LinkedIn, Instagram

Full online monitoring and print monitoring when available. Includesreadership stats and Advertising Value Equivalent

Translation in French, Arabic and Portuguese available