By Nhlanganiso Mkhonta
Mbabane: Despite facing the world’s highest HIV prevalence, Eswatini has made the remarkable achievement of being the first African nation to surpass the UN 2030 target of 95–95–95, Prime Minister Ambrose Mandvulo Dlamini has said.
Writing to South African publication, Daily Maverick, Dlamini said this means that in the kingdom, 95 percent of people living with HIV have been diagnosed, 95 percent of those diagnosed are on treatment, and 95 percent of those on treatment are virally suppressed. “Having reached this goal 10 years ahead of the target, Eswatini becomes the first African nation to achieve this feat,” he said.
The premier told Daily Maverick that this can be attributed to a strong focus on key interventions in testing and treatment, coupled with strong community prevention programming.
“Initially, when HIV-Aids broke out in Eswatini, we had a spiral of infections across the country because it was a relatively new disease for us, and we had little information about how to contain it. With an estimated 27 percent of adults infected with HIV-Aids, our nation was facing a massive health challenge that threatened to destabilise the health system and the nation’s overall economy,” he said.
Dlamini went on to say the country addressed this by using a three-pronged approach: prevention, treatment, and community prevention programming. Our first approach was to encourage abstinence or the use of condoms and sexual exclusivity with one partner to prevent further spread of virus. “We quickly realised that these methods were more useful as temporary measures than permanent solutions,” he said.
The premier said in seeking answers to the kingdom’s burning questions about the rising number of infections in Eswatini, government conducted a study that proved that HIV infection rates were exacerbated by individuals having multiple concurrent partners. He added: “We embarked on several campaigns to drive awareness and share information around the dangers of having multiple concurrent partners and the risk of HIV infection.”
According to the prime minister, between 2005-2007, the country had a major breakthrough when we took a rigid standpoint to make the prevention of mother-to-child transmission of HIV a top priority. He said this dropped the rate of transmission from approximately 30 percent to less than 1 percent. This was a major breakthrough.
As infections began to rise again rapidly in 2011, Dlamini said government decided to focus solely on the cohort that was infected with HIV. “We ring fenced resources for HIV-Aids treatment, ensuring that every person who had been infected had access to ARVs,” he said.
Dlamini also said since then, the approach to treatment has also been inclusive of community programming, adding that government have placed mobile facilities in various communities for mass testing and used door-to-door and index testing, successfully tracking, testing, and providing treatment to infected people across the country.
In addition to ramping up treatment, the prime minister said government have also seen an increase in men opting to be circumcised, a welcome move that has been proven to lower the risk of HIV infection.
“We can now confidently say that we are reducing the number of new infections rapidly, and are providing high quality HIV services to people living with HIV-Aids,” he said.
“The road to achieving 95-95-95 has been long and winding but we are proud to have achieved this feat. However, we are not going to be popping the champagne just yet: we need to continue to ramp up treatment and not become complacent in raising awareness especially among younger generations about the risks of HIV-Aids,” he added.
Dlamini said as the world faces the Covid-19 pandemic, Eswatini will not lose sight of the HIV-Aids epidemic that still has unfinished business.
“To echo the words of United Nations Secretary-General António Guterres, “We must not drop the ball on HIV… We cannot allow the hard-fought gains made in the HIV response to be reversed. Especially as there is still so far to go to finish the job,” he concluded.