An MSF Lab technologist prepares sputum samples at the National TB Reference Laboratory, in Mbabane, Swaziland.
SWAZILAND 2016 © Alexis Huguet
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This information is excerpted from MSF’s 2016 International Activity Report.

In Eswatini, previously known as Swaziland, Doctors Without Borders/Médecins Sans Frontières (MSF) continued to get more HIV patients on antiretroviral (ARV) treatment in 2016 through the “test and start” strategy. MSF piloted the strategy in the Nhlangano project, where, after HIV testing, ARVs were immediately offered to more than 1,700 people who tested positive. Twelve months after treatment initiation, 82 percent of patients had successfully suppressed the virus. As a result, “test and start” was adopted by the Ministry of Health (MOH) as the national standard of HIV care in October.

MSF increasingly focused on providing specialized HIV care, including second- and third-line ARV treatment, cervical cancer screening, and routine point-of-care testing for opportunistic infections. In 2016, 31,784 patients had viral load tests, 407 received second-line HIV care, 1,407 were enrolled in community ARV models of care, and 647 women were screened for cervical cancer (of whom 19 percent tested positive).

In Moneni, MSF started treating patients with extensively drug-resistant TB (XDR-TB) using the promising new drugs bedaquiline and delamanid in combination with repurposed medicines. After six months, almost all of the 81 XDR-TB and multi drug-resistant TB (MDR-TB) patients had reached the stage where TB bacteria could no longer be detected in their sputum. In Manzini, MSF saw a success rate of 75 percent when implementing the shorter DR-TB treatment regimen of nine to 12 months, rather than two years. This regimen has since been recommended by the World Health Organization and was adopted by the MOH as the new national standard of care for MDR-TB treatment, with support from MSF.