UPR Sexual Rights Database

National Report:
Para 58) Eswatini has observed a steady downward trend in Tuberculosis (TB) incidence (363/100,000 population) and TB notifications, TB related mortality and TB/HIV coinfection rates. …
Para 59) Interventions such as intensified TB screening in health care settings and communities, use of rapid molecular TB diagnostic tests, strengthening TB treatment adherence system, scaling up of HIV testing and treatment services in TB settings and commencing TB patients living with HIV on antiretroviral treatment (from 92% in 2016 to 98% in 2020), scaling up of TB preventive services among vulnerable populations such as screening People Living with HIV (PLHIV)for TB and initiating them on TB Preventive treatment (from 1% in 2017 to 65% in 2020) as well as capacity building of healthcare workers have contributed to the observed reductions in TB cases and better treatment outcomes.
Para 61) Eswatini has made tremendous strides towards epidemic control through a focus on key interventions in testing and treatment, coupled with strong community prevention programming. It is estimated that 95% of all PLHIV know their HIV status due to successful case identification and messaging. Early adoption of Test and Start (T&S) programme increased numbers of people on treatment, and strategic interventions to increase access to viral load and to support retention have led to a viral suppression rate of 95% for those who are on ART. According to the 2020 HIV Estimates and Projections Report, new infections have been declining since 2016 from around 8,000 to 4,500 in 2019.
Para 62) The Kingdom of Eswatini had a National Strategic Framework (NSF) from 2014– 2018 which has since been replaced by NSF 2018-2023 to further reduce new HIV Infections. The current NSF 2018-2023 is being implemented and a Mid-term review is ongoing. The country adopted the Test and start for all people-testing positive for HIV, introduced a HIV self-testing programme to encourage people to know their HIV status. Further, community ART groups (CAG) were established which has also reduced AIDS deaths from 2,700 in 2016 to 2,300 in 2020 and the HIV Prevalence has relatively remained around 27% for the past four years.
Para 63) The Prevention of Mother-to-Child Transmission (PMTCT) programming has reduced the mother-to-child transmission (MTCT) to less than 2%17 at 6-8weeks. The country has developed an Elimination of Mother to child transmission of HIV and Syphilis strategy 2018-2022, Integrated HIV guidelines addendum for the amendment of the HIV guidelines 2019 and an operational plan for eMTCT (2020-2022). The Ministry of Health engages communities to sensitize on PMTCT and community health care workers (RHMs and community mentor mothers) for follow-up and home visits of mother and lactating mothers in the community.
Para 65) In response to the impact of COVID-19 pandemic on continuity of services, the Government has expanded its community service delivery to take HIV testing, prevention and treatment services (including ART drug distribution) to people through outreach programmes that rely on rural health motivators and HIV treatment adherence support initiatives. The effect of all these initiatives helped to maintain uninterrupted regimes and to connect with key and vulnerable populations.
Para 66) In 2019, Eswatini conducted a HIV Related Stigma, Discrimination and Human rights survey. The findings were that out of 1136 respondents, 10% experienced HIV related stigma and discrimination in a form of remarks and verbal harassment. The survey has informed the policy and program improvements to address the findings.
Para 67) In the 2018-2023 National Strategic Framework (NSF), social protection and the reduction of structural vulnerabilities including HIV related stigma, key population groups and discrimination form part of the strategic interventions in the implementation of the HIV response in the Kingdom. Further, Non- Government Organizations organise campaigns during events to sensitize the public on HIV related information.
Para 70) The Government is currently implementing SRHR – HIV knows No Borders targeting migrants to ensure their access to healthcare services. This programme further targets communities, religious sector, sex workers, AGYW and LGBTIQs.
Para 71) Eswatini received approximately US $146,580,000 in Overseas Development Assistance in 201720. The health sector has been the largest beneficiary of external assistance; the HIV/AIDS and tuberculosis (TB) epidemics have received a significant response from global development partners and donors. Despite economic challenges, the Government of the Kingdom of Eswatini domestic expenditure in health has risen from $133,009,265 expended in 2017/2018 to the budgeted level of $146,433,314 in 2018/2019. The domestic expenditure on HIV has increased from $23,807,009 spent for the 2017/2018 financial year to $25,438,673 in 2018/2019. ARV purchasing expenses alone accounted for nearly $19,799,308 in expenditure in 2017/2018, and the budget for this increased to over $21,111,037 for 2018/2019.
Para 98) With regards to health care, inmates receive free medical treatment in the Correctional Centres’ clinics. These health care facilities are run by qualified nurses under the supervision of medical officers. The medical team renders comprehensive health care services that include amongst others; curative health services, HIV/AIDS management, tuberculosis management and do make referrals to other hospitals and specialists should there be a necessity.
Para 110) The Kingdom of Eswatini has achieved the 95-95-95 HIV global target set for 2030, which means that 95 % of people living with HIV know their status, 95% of people who know their status are accessing treatment and 95% of people on treatment have suppressed viral load. The success is attributed to the investment in HIV prevention and treatment interventions such as the provision of ART, TB-HIV Coinfection, Voluntary Medical Male Circumcision as well as preventive programmes targeting AGYW amongst others.
Para 111) The Government remains committed to finance HIV response to sustain this achievement and commends the support by the UN and partners including Global Fund, PEPFAR, World Bank and others for providing strategic guidance to the HIV response and ensuring that clear targets are set, shared and consistently monitored.

UN Compilation:
Para 10) While acknowledging the State’s efforts to promote and protect the life and health of persons living with HIV/AIDS, the HR Committee remained concerned at the continued high number of infections in Eswatini and the persistence of stigma and discrimination against such persons.
Para 40) The United Nations country office in Eswatini was concerned that Eswatini had one of the highest HIV prevalence rates in the world, and that the country had a high incidence and prevalence of, and mortality from, tuberculosis. The United Nations country team noted that, further to the State’s commitment to end AIDS as a public health threat by the year 2022, Eswatini had made significant strides in dealing with HIV-related stigma and discrimination through plans and strategies, as revealed by the Stigma Index Survey conducted in 2019.
Para 61) … The country team was also concerned that adolescent girls continued to be disproportionately affected by HIV.

Stakeholder Summary:
Para 13) UPRP-BCU and JS7 indicated that the stigma faced by people with HIV in Eswatini was widespread, particularly affecting women and girls, and that not enough awareness-raising on HIV and AIDS had been carried out. JS7 noted that the stigma attached to the HIV pandemic served as a barrier to HIV treatment and testing.
Para 38) Several stakeholders noted with concern that Eswatini had the highest rate of HIV across the world with more that 27% of adults living with HIV. They indicated that women were disproportionately affected by HIV epidemic. JS7 stated that Eswatini had experienced a growing number of cases of cervical cancer linked to the high rates of HIV prevalence. According to some stakeholders, the perception of women as subordinate to men and resulting gender inequality had increased the vulnerability of women to HIV.