International Activity Report, 2008
Reason for Intervention: Endemic/Epidemic disease
Field Staf 55

Photo: Alexander Glyadyelov

In Swaziland it is estimated that HIV/AID S affects one adult in four, and 80 per cent of patients with tuberculosis (TB) also have HIV. Since November 2007 MSF has been working in the Shiselweni region with public health staff to treat these two diseases.

MSF is decentralising the services offered to HIV-positive people and TB patients in the Shiselweni region. The goal is to establish a one-stop system, to give patients the opportunity to be treated for these two diseases at the same time in the same location by the same health workers. Screening and treatment are now offered at Hlatikulu hospital and in the Nhlangano and Matsanjeni health centres, as well as in nine out of 20 other health centres in the region. In 2008 in the Shiselweni region, nearly 2,300 patients received TB treatment, and 1,870 TB patients co-infected with HIV/AIDS received antiretroviral therapy.

In 2008 an estimated 12,000 new cases of TB were identified in Swaziland, including 200 people who had contracted a form resistant to treatment. Of these, 42 were diagnosed and monitored in Shiselweni. Identifying and treating resistant forms of TB is a priority because of the dangerous and complex nature of the disease.

MSF works directly with communities and people living with HIV/AIDS on prevention and education, research and detection of cases and patient follow-up. Encouraged by their good adherence to treatment, ‘expert patients’ who have personal experience of chronic disease help other patients to gain control of the disease and live positively with HIV/AIDS. MSF has worked in Swaziland since 2007.

Map of MSF/Swaziland Minstry of Health's joint decentralisation project of HIV/TB integrated services in Shiselweni region