The small kingdom of Swaziland in Southern Africa is on the brink of a major health crisis due to the killer twin-epidemic of HIV/AIDS and tuberculosis (TB), which is decimating the population and now sees Swaziland as the state with one of the highest AIDS death rates in the world today.

One in four sexually active adults in Swaziland has HIV/AIDS and an enormous 80 per cent of the tens of thousands of people who have TB, are also infected with HIV. Each year there are roughly 14,000 new TB cases diagnosed among this small population of just over 1.1 million people, of whom over a 25 per cent are HIV positive.

This double epidemic of HIV/AIDS and TB means that life expectancy has fallen to under 32 years, and Swaziland’s already fragile health system is struggling to cope with this public health crisis.

From Oct. 28 to 30, the Ministry of Health of the Kingdom of Swaziland and Médecins Sans Frontières (MSF) will bring together international and local experts in a consultative workshop. They will discuss the public health response to the combined drug resistant tuberculosis and HIV/AIDS crisis in the southern African region, with the aim of finding practical solutions for countries in the region with a high prevalence of HIV and TB.

The Swaziland Ministry of Health and Médecins Sans Frontières teams working in the country have faced numerous challenges in the implementation of a decentralized model of care, suitable to rural settings affected by high drug resistant TB and HIV prevalence. These difficulties call for more innovative solutions, that will benefit the majority of TB and HIV patients in need of treatment, adapted to the Swaziland reality – highest HIV prevalence and TB notification rate in the world, limited number of medical doctors, inconsistent HIV and DR TB drug supply, poor drug resistant TB diagnostics, etc.

MSF has been working in the Shiselweni region, south of Swaziland, since November 2007.

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