The National Multisectoral HIV and AIDS Strategic Framework (NSF) 2018-2023 is a five year policy and planning document that has been developed to guide focused resource allocation, programming and implementation of the HIV response in the Kingdom of Eswatini. The vision for this NSF is to End AIDS as a public health threat by 2022 through epidemic control by focusing on drastically reducing new infections and AIDS-related deaths.
The National Multisectoral HIV and AIDS Strategic Framework 2018-2023 is influenced by our people, informed by our partner agencies and stakeholders, and shaped by the expectations of the people of the Kingdom of Eswatini.
NSF Strategic Interventions
THE NSF HAS THREE STRATEGIC INTERVENTIONS:
1. Social and behaviour change(SBC)
2. Condom Promotion and Distribution
3. Economic empowerment for adolescents and young people
4. Voluntary Medical Male Circumcision (VMMC)
5. Pre-Exposure Prophylaxis (PrEP)
6. Post Exposure Prophylaxis (PEP)
7. Prevention of Mother to Child Transmission (PMTCT)
8. Management and Treatment of Sexually Transmitted Infections (STI)
HIV TREATMENT, CARE AND SUPPORT
. 1. HIV Testing services (HTS)
Antiretroviral therapy (ART)
Retention and viral suppression
2. Management and treatment of TB/HIV co-infection
SOCIAL PROTECTION AND REDUCTION OF STRUCTURAL VULNERABILITIES
1. Support to orphaned and vulnerable children (OVC)
2. Gender Based Violence
3. HIV related stigma, discrimination and human rights
THE THEMES INFORM OUR PLANNING, GUIDE OUR ACTIONS, AND HELP US TO SET OUR PRIORITIES AND ACHIEVE OUR PURPOSE AND MENDATE.
NERCHA is greateful for the support provided by the Technical Advisory Teams from the United Nations offices in the Kingdom of Eswatini, UNAIDS, and the United States Government's PEPFAR team. The World Bank is commended for providing an independent external perr review of the NSF.
The Kingdom of Eswatini has made its commitment to End AIDS as a public health threat by the year 2022. this target was initiated in 2015 as a pledge towards a First World Eswatini and is in line with the global HIV/AIDS targets for 2030. Our commitment has seen an elaboration of plans and strategies to prevent new HIV infections and AIDS deaths through a multisectoral response, with the most recent being the extended National Strategic Framework (eNSF) and the Umgubudla Fast Track to End AIDS programme.
Through implementation of these initiatives, the Kingdom is proud to report that new infections have reduced by 44 percent since 2014, against a target of 50 percent. Over 80 percent of people living with HIV are alive and on treatment, and over 90 percent of those are virally suppressed. Moreover, the country has made large domestic investments in its HIV response, with public funds supporting 40 percent of the total cost and Governemt paying for virtually all antiretroviral drugs, since 2010.
Inspite of all the gains, HIV and AIDS will continue to be high on the national agenda. This is because some sub-populations have not benefited from the strides made in prevention and treatment, with more than 2,500 new HIV infections occuring each yearamong young people aged 15-24, and with 15% of people living with HIV (PLHIV) not having tested and enrolled in care, the majority of whom being men and children under the age of 14 years. Furthermore, other disease co-morbidities have emerged that pose a threat to the lives of those living with HIV.
To reverse this, we must continously remain aware that AIDS is preventable and manageable. We must intensify and expand the measures at our disposal to prevent its spread and impact. The most important is to, firstly, make HIV prevention for the over 700,000 emaSwati who are HIV negative a priority, and, secondly, equally important to ensure that those who are living with HIV receive timely and quality HIV treatment to prevent their progression to AIDS. Thirdly, we must recognise that a multisectoral response is imperative to sustain the gains made, and we should, and we should collectively reduce all structural vulnerabilities that impede progress. This includes a broad ecenomic resuscitation to support the fiscal demands of the lifetime treatment programme, economic empowerment of young people and the creation of a resilient social support system for those who are disproportionately affected by its impact.
This NSF 2018-2023 has been developed to super-fast track those ideals by detailing strategies that reach individuals, social networks, communities, and promote social change. It has been developed against the backdrop of unstable and unpredictable financial resource climate, owing to the global flat-lining of resources for HIV/AIDS. Furthermore, our Government is faced with resource constraints in the light of extensive development priorities. In recognition of the realities, the NSF has included a chapter on innovative measures to support the fiscal sustainability of the response.
Finally, I again call for renewed commitment from all stakeholders in government, civil society, communities, people living with HIV/AIDS and the country's development partners to make this dream possible. Our dream is to End AIDS by 2022.
Dr. Barnabas Sibusiso Dlamini
Kingdom of Eswatini