‡‘•–”ƒ–‹‘ ‘ˆ ™Šƒ– ’‘Ž‹–‹…ƒŽ ™‹ŽŽǡ ‡ˆˆ‡…–‹˜‡ Ž‡ƒ†‡”•Š‹’ …ƒ †‘

7

+( kingdom once again shared its success story with the world when the Government of Eswatini and the US President’s Emergency Plan for AIDS Relief, also called PEPFAR, announced the results of the 2021 Eswatini population-based HIV Impact Assessment Survey (SHIMS 3), which demonstrated the sustained progress towards the UNAIDS 95-95-95 targets. This report revealed once again that in Eswatini 94 per cent of adults 15 years and older living with HIV know their status; 97 per cent of those are on antiretroviral therapy (ART) and 96 per cent have achieved viral suppression. This was compared to the SHIM 2 (2016-2017) results of 87-89-91. Women achieved 95-98-96 in SHIMS 3 while males reached 92-96-97.

These positive results come against the backdrop of then COVID-19 pandemic, which threatened gains made as services were seriously disrupted but with innovative strategies, strong partnerships and effective leadership programmes delivery continued. The game changer is that Eswatini used data-driven approaches to ensure that the number of people who tested increased, adopted the µtest and treat’for rapid initiation on ART for those who tested HIV positive and enhanced national capacity for viral load testing to monitor the response to ART. To mitigate effects of COVID-19, the innovations included the implementation of a six-month dispensing of ART and decentralising the distribution of medicines and healthcare services at community access points beyond health facilities. These strategies minimised disruptions and supported the strong outcomes.

During the SHIMS 3 launch, the Minister of Health, /izzie Nkosi, underscored the country’s leadership commitment and prioritisation of HIV prevention and treatment as critical for the success. She applauded those who live with HIV for having maximised opportunities through HIV programmes while the US Global Health Ambassador, Dr John Nkengasong, noted that; “Eswatini implemented a multi-pronged approach to achieving UNAIDS targets that has been successful.´ Wafaaa El-Sadr, Global Director of ICAP, noted that; “Eswatini is to be congratulated for its HIV response. One that is distinguished by a determined leadership, a laser focused on gaps in services and by attention to the uniTue needs and priorities of recipients of care.´

Progress

The US Ambassador to Eswatini, Jean Maloney, said; “Eswatini exemplifies the tremendous progress that can be made when governments, multilaterals, partners and civil society come together with a unified purpose.´ She further stressed µthat sustained leadership across government is needed to holistically address the underlying and drivers of new infection, including gender-based violence, to protect vulnerable situations’.

/et us recall that in the early 90s Eswatini was known to have the worst HIV prevalence in the world. This situation impacted negatively socio-economic gains where life expectancy fell from 60 in 1997 to 47 for females and 43 for males in 2007. The impact had profound implications on the socio-economic status of the country, resulting in a high mortality rate among the productive age group, forcing the country to allocate massive resources to fight the scourge. In the absence of treatment