Eswatini

We now treat patients with extensively drug-resistant TB (XDR-TB), and those developing severe side effects, using the promising new drugs bedaquiline and delamanid in combination with repurposed drugs.

MSF teams are currently responding to the coronavirus COVID-19 pandemic in Eswatini.

We strengthened community-based drug-resistant TB (DR-TB) care, with health workers visiting patients’ homes to give them medication, food, psychological support, and COVID-19 preventive equipment (masks, sanitizers). Video-observed treatment allowed these patients to film themselves taking their medication at home, instead of traveling to health facilities for nurse-observed treatment. In addition, we increased our support to the national DR-TB ward in Shiselweni, by providing nursing care, implementing COVID-19 prevention and detection protocols, and donating medicines.

To relieve pressure on health facilities as COVID-19 cases surged, we set up mobile clinics and a health post to offer care for TB, HIV, and NCDs such as hypertension and diabetes. Our services included testing, screening, medication refills, and advice on COVID-19 prevention.

We also incorporated care for NCDs into general health care facilities, and increased the services offered at our community site in Nhlangano to cover HIV self-testing, pre-exposure prophylaxis to prevent HIV infection, family planning, and treatment for HIV and sexually transmitted infections. In 2020, we completed a study looking at diagnosing and treating HIV earlier during the window period – the time between infection and the point when a test gives an accurate result. This will guide our future work on HIV epidemic control.

Other COVID-19 activities included supporting the health authorities to increase testing capacity, and sending an MSF community team to provide home-based care and refer critically ill patients for oxygen therapy.