Your Excellency, the Right Honorable Prime Minister;
Honorable Minister of Health;
Principal Secretary, Ministry of Health;
UN Resident Coordinator;
Representatives from ICAP, NERCHA, and SNAP;
PEPFAR and CDC Team Members;
Members of the Diplomatic Corps;
Members of the press;
Ladies and Gentlemen,
For all of you who have worked on the SHIMS 1 and 2 Surveys over the past 6 years, this is an important day. I especially want to acknowledge the unwavering dedication and incredible work of various partner organizations involved in this research. The Government of the Kingdom of Swaziland, through the Ministry of Health, NERCHA, and the Central Statistics Office, provided exceptional stewardship of these programs. ICAP at Columbia University was the primary implementing partner and lent its capacity-building expertise to the process. The UN family, implementing partners, and community leaders have been pivotal at every stage of survey implementation. And I am especially grateful to our outstanding PEPFAR team, whose tenacity and sheer perseverance are unmatched.
The relationship between the U.S. government, the Government of the Kingdom of Swaziland, and our partners has steadily evolved over the years. The depth of our cooperation cannot be understated, for it has become a true friendship – able to adapt to ever-changing staff, new information, and fresh ideas. In many ways, our collaboration stands as a testament to what is achievable when we all focus on a common vision and goal.
In 2011, we supported the launch of SHIMS 1, which was the first survey of its kind in the world to directly measure the rate of new HIV infections in the population. It served as the prototype for the next wave of 13 population-based HIV Impact Assessment Surveys in various PEPFAR-supported countries. These surveys are a critical tool in responding to HIV because they can tell us, in real-time, the status of the epidemic. They can also contribute to calibrating projection models that have been developed by UNAIDS and other partners. The data contained in the surveys will answer key programmatic questions, thereby enhancing the current response.
The Swazi government’s ownership of both SHIMS surveys is the primary driver of the program’s success. This ownership has also driven the dramatic programmatic shifts since 2011 to combat the HIV epidemic in the country. The national response has been decisive, comprehensive, and timely. The government’s commitment to provide first-line anti-retroviral drugs demonstrates a seriousness of purpose that not all countries in this struggle can match. We look forward to the government maintaining this commitment and, in keeping with Swaziland’s own development goals, progressively taking on more of the financial responsibility for this effort.
PEPFAR has been proud to be with you on this journey. Over the past five years, the U.S. government’s commitment – both in human and financial resources – has consistently grown. Our support for HIV/AIDS programs in Swaziland outpaces every other foreign country – and this is not by accident. Our support now stands at more than $50 million per year thanks to strong allies, both Republican and Democrat, in our United States Congress. The message is clear – these issues matter.
PEPFAR Swaziland leverages Swaziland’s National Response by providing resources, technical assistance, and capacity-building to ensure that interventions complement and augment existing programs. These funds provide high quality HIV/AIDS-related services while strengthening capacity of organizations and quality of programs. On the ground, this translates into helping to prevent mother-to-child HIV transmission; supporting social and behavioral change interventions; engaging with communities; providing voluntary medical male circumcision services; expanding access to counseling and testing; linking to care and treatment, including viral load monitoring; improving the availability of laboratory services; and strengthening national supply chain and drug management systems. PEPFAR also provides institutional and human capacity building to address gaps in the public health system, and to strengthen strategic information expertise. Taken together, these actions form a holistic approach to responding to the HIV/AIDS pandemic.
Swaziland is also a designated DREAMS country, determined to build resilience in adolescent girls, young women, and men in 19 of the 55 Tinkhundla over the next two years. This investment of $10 million not only lays the foundation for Swaziland to reach its goal of an AIDS-free generation, but it helps youth prioritize their health and encourages them to adopt responsible behaviors.
Through the implementation of SHIMS 2, the Swaziland Health Laboratory Services (SHLS), Central Statistics Office, Health Research Unit, and Epidemiology and Disease Control Unit gained valuable knowledge and access to key resources to collect, monitor, and evaluate data. In addition, the Health Research Training Program, which has trained 4 cohorts of mid-career health professionals in the country on research methodology, will be engaged to analyze SHIMS 2 data, contributing to the scientific body of knowledge in the country. Acquiring this in-house knowledge and capacity – and building on it – will ensure that the Government of the Kingdom of Swaziland can continue to effectively manage its HIV response.
Before I conclude, I’d like to pause for a moment for us all to think about what the menu I just laid out of programs, resources, and technical assistance really means. Think about your own experiences with HIV 15 years ago and what the prospects for success looked like at that moment in time. For me, it was living in a country where the road to the cemetery had daily traffic jams and where the first action of a newly arrived coworker was to attend the funeral of one of his staff members who had died of AIDS. In those days, it was extremely difficult to envision success against this epidemic. But just look at where we are now. Many more people can access care and treatment, thanks to decentralized care and treatment services and innovations such as taking testing services into communities rather than keeping them at clinics. The government’s move to test and start means that people can immediately access treatment, which is good for them and their partners. The young people reaching adulthood in Swaziland, who are a large wave about to wash over this country, can now have bright health prospects. But these young people pose a whole new set of challenges that will require us all to ensure that we continue to find new and innovative ways to get ahead of the disease.
Throughout my career in Africa, I’ve come across many proverbs that seem to perfectly capture the essence of our collective humanity, our shared values, our hopes and dreams. One that particularly suits this occasion says: “Nawufuna kuphutfuma hamba wedvwa. Nawufuna kuhamba libanga lelidze, hamba nalabanye.” (If you want to go fast, go alone. If you want to go far, go together.) Today shows the evidence of what we have done together, one centimeter or one statistic at a time. We look forward to continuing this journey with you until we reach the destination of an AIDS-free generation.