The Government of the Kingdom of Swaziland (GOKS) has established clear national priorities and strategies to fight the HIV/AIDS epidemic within its borders through its recently revised National Strategic Framework (NSF) (2009-2014).  Through The United States President’s Emergency Fund for AIDS Relief (PEPFAR), the U.S. Government (USG) and its partners are supporting Swaziland to implement its NSF by providing technical expertise and financial support.  This partnership has furthered strengthened by the signing of the PEPFAR Partnership Framework in June 2009, a 5 year collaborative agreement that defined future GOKS and PEPFAR activities in the fight against the pandemic. The Partnership Framework further emphasizes the principles of building sustainable country-led programs that include gender sensitive programming.

PEPFAR Swaziland leverages Swaziland’s National Response by providing  resources, technical assistance, and capacity-building to ensure that interventions complement and build on existing programs and provide high quality HIV/AIDS related services while  strengthening capacity of organizations and quality of programs. It works with the government of Swaziland and facilitates implementation of strategic projects through community-based organizations, faith-based and non-governmental organizations as well as the business sector. Furthermore, PEPFAR also coordinates and collaborates with other donors and other development programs to strengthen linkages and ensure a holistic and complementary approach to tackling HIV/AIDS in Swaziland.


Eliminating Pediatric AIDS – working with the Government of Swaziland towards the elimination of mother to child transmission of HIV by ensuring universal access to the Prevention of Mother to Child Transmission (PMTCT) services.  This includes assuring sustained quality, comprehensive, integrated PMTCT services at GKOS health facilities; training and mentoring service providers, promoting services through community outreach; and providing psycho-social support to HIV pregnant women and mothers.

Combination Prevention–  implements effective and tested interventions that support national efforts through:

  • Structural interventions that create an enabling policy environment and strengthen  leadership for HIV prevention;
  • Social and behavior change interventions that reduce the risk of HIV infection, promote health seeking behaviors, and enhance protective social and gender norms;  and
  • Biomedical interventions that expand uptake and use of condoms and high impact services including medical male circumcision (male circumcision greatly decreases the risk of HIV infection among heterosexual males) and treatment.

Impact Mitigation: – supports strengthening of government and community systems to mitigate the impact of HIV/AIDS on children and their caregivers, and funds community-based organizations to deliver quality child-focused services in the areas of economic strengthening, education, health and protection. Systems strengthening focus on the social welfare workforce, and enhanced monitoring and evaluation for impact mitigation.

Gender Mainstreaming– in addition to programs that directly target women and girls, implement activities across the PEPFAR portfolio that increase male involvement in family-centered programs and address norms around behaviors that make women and girls vulnerable to HIV and gender-based violence (GBV)

Human Resources for Health – Within Health Systems Strengthening, PEPFAR supports human resources development and institutional capacity building to support all the other 4 pillars of the Partnership Framework (2009-2013).  This is directly responding human resources shortages in health and social welfare that are a priority for PEPFAR, leveraging on investments made in health and impact mitigation.  Emphasis is on creating HR systems to ensure that workforce planning, development and management are efficient and the skills are retained in the public sector, private sector, and NGO sector. Imbalances in development of some cadres are impacting on the decentralization of services.  It is USG priority to support the up scaling of cadres such as: midwifery, medical laboratory technologists, pharmacy technicians and social welfare workers in the pre-service strategy.  

Linkages / Testing and Counseling – scale up provider-initiated & community-based  HIV counseling and testing services, while vastly reducing ‘leakages’ in referral systems.

Treatment & Care Services – supports the Ministry of health and implementing partners in building the capacity to improve coverage and the quality of HIV and TB care and treatment services.  This includes provision of clinical and community-based services, mentoring, laboratory support, provider and client-initiated HIV testing and counseling services, and blood safety programming.   The goal is to combine these efforts with PMTCT and MC activities into an effective and focused combination prevention program.

Decentralization of Care and Treatment Services –supporting implementation of HIV and TB-related components of the Essential Health Care Package (EHCP) from referral hospitals to community health centers. Launched in early 2012, the EHCP is the nation’s first description of the health services that should be available to every citizen. This will enable MOH establish standards for the health system and measure achievement transparently, thereby  improving both access to and quality of health care in Swaziland.

Research / strategic information – supporting national institutions to enhance generation, analysis, dissemination and use of data for programs and policy.  Building of the 2011 success of SHIMS (the Swaziland HIV Incidence Measurement Survey), a first of its kind national incidence measurement, PEPFAR is supporting the development of a Health Research Training Project to be launched in early 2013.

Health Systems Strengthening and Infrastructure – in coordination with government and international development partners, strengthening routine reporting systems, diagnostics and laboratory systems, and small-scale, targeted infrastructure renovation projects to drive the decentralization of HIV and TB care and treatment, as well as social welfare, services. In addition, improving efficiencies by strengthening leadership forums and developing quality systems.

Lab / Blood Safety – Scaling up of Viral load Testing,   GeneXpert placement to minimize use of smear ZN screening, also embarking on a pilot study for non-communicable diseases screening (Glycosylated Haemoglobin) and study on Rota Virus & Cryptococcus screening, as well as Decentralization of Blood Transfusion Services to all health facilities including clinics.

Find out more about PEPFAR

The Country Coordination Office of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in Swaziland disseminates stories of hope about men, women, and children who are infected and affected by HIV/AIDS across the country. For any questions or comments about PEPFAR programs, please contact the Country Coordinator at Tel: +268 2417-9000 or write to:

P.O. Box D202,
The Gables, Eswatini.
Tel: +268 2417 9000
Fax: +268 2416 3344

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