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PublicationsInternational Activity Report 2007SwazilandDespite a relatively stable political situation and what appears to be a reasonable resource base, about 69 per cent of the population of Swaziland still lives below the poverty line. The health situation, which had improved in the 1980s and 1990s, has entered a downward trend as a consequence of the HIV/AIDS and tuberculosis (TB) epidemics. In November, MSF launched a project to support the national authorities in providing decentralized care to people affected by HIV and TB. Both diseases have already had a devastating effect on the population and the economy. Life expectancy at birth is only 32.5 years, the lowest in the world. The country has the world’s highest HIV prevalence rate and one of the highest levels of HIV-TB co-infection. Twenty-six per cent of young adults are infected with HIV and may die in the coming years if not given adequate treatment. With the escalation of the HIV and TB epidemics, health infrastructures risk being overwhelmed. In November, MSF opened a project in the region of Shiselweni, populated by some 202,000 inhabitants. MSF works in the hospital of Hlatikulu, in two healthcare centers in Nhlangano and Matsanjeni and in 19 rural health clinics throughout the region. This project aims to reduce mortality from HIV/AIDS and TB and to improve access to anti-retroviral treatment (ART) and TB treatment for those who urgently need it. In collaboration with the health authorities, MSF is focusing on decentralizing integrated care for HIV/AIDS and TB to the level of the health clinics, the closest health facilities to the population. The strategy relies on wide community involvement to enable prevention, testing and adherence to treatment. This is achieved through the contribution of health workers and people living with HIV/ AIDS, known as ‘expert patients’, who provide peer support and guidance. Special emphasis is put on the improvement of prevention and diagnostics, notably through carrying out complete tests for HIV/AIDS and TB. MSF also provides comprehensive care for complex cases of HIV/AIDS and TB, including patients with multi-drug resistant TB. In 2008, MSF aims to start 3,000 new patients on ART in the Shiselweni region. MSF has worked in Swaziland since 2007. |
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