CDC in Eswatini

HIV is a leading cause of death and a health threat to millions worldwide. As a key implementer of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC works with Eswatini to build a sustainable, high-impact national HIV response program to accelerate progress towards the UNAIDS global targets to control the HIV epidemic by the year 2020.

CDC works closely with the Ministry of Health (MOH) and other partners to improve the coverage and quality of HIV and tuberculosis (TB) treatment services throughout the country. CDC supports the Eswatini National AIDS Program and the National TB Control Program to

• Improve provider and client-initiated HIV testing and counseling services.
• Prevent mother-to-child transmission (PMTCT) of HIV.
• Improve pediatric and adult antiretroviral treatment (ART) programs.
• Assist the MOH in its efforts to link people testing positive for HIV to appropriate services and retain them in treatment services.
• Improve provider and client- initiated HIV testing and counseling services, prevention of mother-to-child transmission (PMTCT) of HIV, and pediatric and adult antiretroviral treatment (ART) programs.

CDC assists the MOH in planning and implementing high quality, decentralized HIV testing and treatment services (including scaling-up HIV index and self-testing, Test and Start, and routine viral load monitoring). Community HIV testing services are enhanced under the ARROWS project (ART Referral, Retention, and Ongoing Wellness Support).

CDC supported the Government of Eswatini to successfully conduct the HIV Incidence Measurement Survey 2, which is a part of the global population-based HIV impact assessment initiative. The survey was conducted from August 2016 to April 2017, and preliminary results were disseminated in July 2017.

CDC also supports the MOH’s Health Research Training Program, which trains mid-career professionals with the health care system on research methodology. CDC supports the MOH’s health research units and epidemiology and disease control unit, as well as the central statistics office to promote routine collection, use, and dissemination of data for effective programming and public health policy making development.

All CDC-supported facilities are assessed through the site improvement monitoring system to check the quality of service delivery and increase impact. Data is presented at regional and national HIV semi-annual reviews. These management review meetings, organized by the MOH and supported by CDC, provide site, regional, and national-level performance feedback to health providers and program implementers.

Eswatini has significantly improved its laboratory capacity to perform viral load testing, enabling the country to move from targeted to routine viral load testing. CDC assisted with the implementation of the World Health Organization’s stepwise laboratory improvement process toward accreditation that is ongoing through all major public laboratories in the country.