Near an HIV free generation? It's happening in Eswatini

Near an HIV free generation? It's happening in Eswatini

In 2011, we had a big dream: to ensure immediate access to ART for all people living with HIV in Eswatini, with the ultimate goal of ending the HIV epidemic. Bold and unearmarked support of the Dutch Postcode Lottery enabled us to develop our dream into the MaxART programme and implementation study: A unique possibility to assess feasibility, acceptability, clinical outcomes, affordability, and scalability of offering ART to all people living with HIV regardless of CD4-count in a government-managed health system.

MaxART programme

The Ministry of Health took the lead in our collective effort of a multi-disciplinary group of partners.  We supported 14 clinics in Hhohho region to make the successful transition to providing ART to all. We invested in training of health workers and strengthening health systems to enhance testing and improve services and data collection. We informed communities and linked them better to formal health services. We reached out to specific target groups, including men and young people.  And we made sure that there were continuous feedback loops between communities, health services and the Ministry.

“There is no fear in the communities. People talk freely on their HIV status because they are empowered on health issues”Sibongile Mnisi, regional coordinator Hhohho region at SWANNEPHA

Results

Our research shows that Early Access is acceptable for clients and retention increased. Providing early ART proved to have a large effect on viral suppression and does not enhance public sector costs. It did not negatively affect adherence and disclosure. In other words, MaxART demonstrated that providing Early Access to ART through the public health system is feasible, acceptable and highly effective. Our results strongly support the scale-up of Early Access to ART for All in Eswatini and countries with similar HIV epidemics and health systems. Through early ART we can build an HIV free generation. 

infographic results maxart

 

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