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 Wednesday 16 June 2010
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Country Profile: Swaziland
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AIDS Programmes

National Strategic Framework: 2006-2008

Reflecting a new thinking within in government—HIV/AIDS as not just a health problem but a development problem— the document promotes a wholistic approach the pandemic and includes provisions for HIV/AIDS information and life skills to be incorporated into school curriculum. The document also draws from the ABC approach adopted by countries such as Uganda. Other features of the document include:
 Promoting male involvement in home-based care
 Promoting research into traditional medicine as part of a partnership between traditional and medically-trained caregivers
 A promise to review traditional practices impinging on the rights of widows and orphans such as wife inheritance and restrictions on the inheriting of property

Epidemiological Assessment (WHO):
Major vulnerable and affected groups
The primary mode of transmission is heterosexual contact. The population group most affected by HIV/AIDS is women 20–24 years old. No information is available on the HIV prevalence rate among sex workers. Men and women with sexually transmitted infections have high HIV prevalence rates.

Policy on HIV testing and treatment
HIV testing is available through testing and counselling services linked to health services (clinics for tuberculosis, sexually transmitted infections, preventing mother-to-child transmission and others) or through stand-alone voluntary counselling and testing clinics and outreach mobile units. Guidelines on voluntary counselling and testing have been developed. HIV testing is voluntary and confidential. Pretest counselling and informed consent are required, and test results are provided after post-test counselling. Testing is mandatory only for blood transfusion

Critical issues and major challenges
Lack of human resources capacity is a major challenge to scaling up antiretroviral therapy in Swaziland. The recruitment and retention of staff is constrained by poor working conditions and limited incentives. The availability of health workers is further declining due to HIV. A system to ensure the continuous supply and distribution of AIDS medicines and diagnostics needs to be established. The various agencies involved in procuring, storing and supplying drugs need to harmonize their efforts, including the Government Tender Board, the Central Medical Stores and the care centres. Laboratory capacity is being strengthened at the central level; the same needs to be done at the regional level. The Swaziland National HIV/AIDS Programme of the Ministry of Health and Social Welfare needs to be strengthened to be able to adequately manage, implement and monitor programmes. HIV prevention strategies need to be strengthened. An integrated strategy for information, education and communication needs to be developed targeting young people and vulnerable populations. Community-based organizations need to be strengthened to provide adherence and psychosocial support to people living with HIV/AIDS. An efficient monitoring and evaluation and referral system needs to be developed to ensure appropriate follow-up of people receiving antiretroviral therapy.

HIV/AIDS Organisations

  National Emergency Response Committee on HIV/AIDS (NERCHA)
Contact person: Dr Derek Von Wissel, director Tel: +268 404 1708
Location: +266 404 1720
  Fax: +268 404 1692
What we do:

  Swaziland National AIDS Programme (SNAP)
Contact person: Dr Velephi Okello, antiretroviral therapy focal person Tel: +268 404 8440/1
+268 404 5397
Location: P.O. Box 1119
Mbabane, Swaziland
Fax: +268 404 8209
What we do: Prevention of HIV/AIDS/STI - production of IEC materials and condom promotion and distributio. Research and surveillance - data collection and reporting of AIDS cases;and HIV/AIDS sentinel surveillance which has been recently completed; developing guidelines on PMTCT, voluntary counselling as well as hone-based care programmes.

  The AIDS Information Support Centre (TASC)
Contact person: Thandi Nhlengethwa, head of programme Tel: +268 505 4790
Location: P.O. Box 1279
Manzini, Swaziland
What we do: HIV/AIDS information, education and communication strategies; mass media HIV/AIDS information dissemination; condom promotion and distribution; voluntary walk-ins for counselling and testing; telephone helpline; training and programme support.

 Baphalali Swaziland Red Cross Society
Contact person: Elliot Jele, hHealth, HIV/AIDS programme manager Tel: +268 404 2532
Location: 104 Dzeliwe Street
P.O. Box 377
Mbabane, Swaziland
Fax: +268 404 6108
What we do: Information; advice; care and support; training, capacity building advocacy; counselling.

 The Family Life Association of Swaziland (FLAS)
Contact person: Cedric Musa Mgogo, executive director Tel: +268 505 3082 / +268 505 3086
Location: Dudu Simelane, deputy executive director
P.O. Box 1051
Manzini, Swaziland
Fax: +268 505 3191
What we do: Provision of comprehensive and holistic sexual and reproductive health (SRH) information and services with special focus on youth.

 FLAS Youth Team
Contact person: Petros Dlamini, youth affairs manager Tel: +268 505 3082 / +268 505 3088
Location: P.O. Box 1051, Manzini, Swaziland Mobile: +268 605 3800
Fax: +268 505 3191
What we do: Programes for prevention and reduction of unwanted pregnancies; maternal mortality; sexually transmitted infections; unsafe abortion and HIV/AIDS.

 Hlanganani Help Centre - working with: Municipal HIV/AIDS Team (MHI)
Contact person: Rhumelele Thwaza Tel: +268 505 2481/3
Location: P.O. Box 418
Manzini, Swaziland
Fax: +268 505 3992
What we do: Self help, information; advice; support; advocacy; counselling.

 Population Services International (PSI)
Contact person: Babazile Dhlamini, programme manager Tel: +268 505 2157/62 505 2157
Location: Fax: +268 505 2130
What we do: Uses social marketing to deliver health products, services and information that enable low-income and other vulnerable people to lead healthier lives.

 Swaziland AIDS Support Organisation
Contact person:  Ms. Nonhlanhla Nkambule Tel: +268 422 1640 / +268 422 0661
Location: P.O. Box 6102
Mababane, Swaziland
Fax: +268 422 0663
What we do: National network facilitating research, exchange of information, access to resources, policy influence and advocacy, capacity building and providing technical assistance to its members, thus enhancing their capacities to mitigate the spread of HIV.

 Swaziland Hospice at Home
Contact person: Thulile Dlamini-Msane Tel: +268 518 4485 / +268 518 6737
Location: P.O. Box 23
Matsapha, Swaziland
Fax: +268 518 6405
What we do: Care and support; counselling; training for health professionals and the public; bereavement support.

 Swaziland AIDS Support Organisation (SASO)
Contact person: Hannie Dlamini Tel: +268 422 1640
Location: P.O. Box 6102
Mbabane, Swaziland
Mobile: +268 605 2776
  Fax: +268 422 0663
What we do: Self-help; information; education; prevention; advocacy; lobbying; counselling.

 Swaziland Positive Living for Life
Contact person: Ms Siphiwe Hlophe Tel: +268 505 7088
Location: P.O. Box 2030
Manzini, Swaziland
Mobile: +268 605 7782
  Fax: +268 505 8538
What we do: HIV/AIDS awareness; information; education; prevention; advocacy; lobbying; counselling.

 UNAIDS Country Co-ordinator
Contact person: Ms Mulunesh Tennagashaw Tel: +268 404 8559 / +268 405 0651
Location: P.O. Box 261
Mbabane, Swaziland
Fax: +268 404 9931
What we do: UNAIDS leads, strengthens and supports an expanded response aimed at preventing transmission of HIV, providing care and support, reducing the vulnerability of individuals and communities to HIV/AIDS.

 UN Theme Group on HIV/AIDS, Chair
Contact person: Dr David Okello, WHO Tel: +268 404 2928 / +268 404 4268
Location: 1st Floor New Mall Building
P.O. Box 903
Mbabane, Swaziland
Mobile:  +268 602 0960
  Fax: +268 404 4566
What we do: Supports an expanded response and policy advice on preventing transmission of HIV, providing care and support, reducing the vulnerability of individuals and communities to HIV/AIDS.

Sources: - The Presidents Emergency Plan for AIDS Relief (PEPFAR)
- The World Bank
- World Health Organization
- United Nations Educational, Scientific and Cultural Organization (UNESCO) Country Profiles
- United Nations Population Division, Department of Economic and Social Affairs. 2005. “World Population Prospects: The 2004 Revision.” New York.
- The Joint United Nations Programme on HIV/AIDS (UNAIDS)

Treatment Map

Adult HIV Prevalence Rate (%): 33.4%
No. Of People living with HIV/AIDS: 220,000
No. Of HIV Testing & Counselling Sites: 37
No. Of People in need of ART (Oct. 2006): 30,000
No. Of People On ART (Sept. 2006): 15,357
No. Of Sites Reportedly Distributing ART (Oct. 2006): 19 in the public sector as well as 6 sites run by Good Shepard Hospitals, an NGO.
No. Of People on ART Public Sector (Oct. 2006): 9,816
No. Of People on ART Private Sector (Oct. 2006): 867
No. Of People on ART in Non-Governmental Programmes (Oct. 2006): 4,674
No. Of People Expected to be on ART (2006 End): 21,000
Front Line Drug Regimen (Oct. 2006): stavudine + lamivudine + nevirapine, also known as Triommune
*PMTCT Regimen (Oct. 2006): Zidovudine (AZT) from 28 weeks and nevirapine with single dose at beginning of labour

HIV/AIDS Fund Disbursements:
Total Funds Disbursed By The Global Fund as of Sept. 2006: US$39,531,248 (Swaziland also receives additional funding from the Global Fund in the form of an allocation for a cross-border area comprising parts of Mozambique, South Africa and Swaziland.)
Total Funds Disbursed By The World Bank Multi-Country HIV/AIDS Programme (MAP) as of Sept. 2006: nil
Total Funds Disbursed By PEPFAR During 2005 Fiscal Year: nil

Sources: National Emergency Response Committee on HIV/AIDS (NERCHA)


Demographics (United Nations Population Fund):
Population: 1,032,000
Population aged 15-59: 553,000
Urban population: 246,000

Under 5 mortality per 1000 births: 143
Male life expectancy: 36 years
Female life expectancy: 39 years
Combined average life expectancy: 37.5 years
Combined average life expectancy 1975-1980: 52.6 years

Education (UNESCO, 2004):
Males with secondary education as percentage of secondary school-age youths: 42 percent
Females with secondary education as percentage of secondary school-age youths: 43 percent

Literacy rates (UNESCO, 2004):
Percentage of literate males aged 15 or older: 82 percent
Percentage of literate females aged 15 or older: 80 percent
Combined literacy rate for aged 15 or older: 80.9 percent
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