Epidemiology

An outpatient nurse performs physiotherapy on an HIV patient at his home in Swaziland

The HIV/AIDS epidemic has spread relentlessly in Swaziland since the first case was reported in 1986. The U.S. Agency for International Development reports that an alarming 56% of women ages 25-29 in Swaziland are HIV positive and life expectancy for Swaziland's population overall has been nearly cut in half, from 61 years in 2000, to 32 years in 2009.

The United Nations Development Program notes that if the spread of the HIV/AIDS epidemic in the country continues unabated, the "longer term existence of Swaziland as a country will be seriously threatened."

In response to this crisis, ICAP at Columbia University, part of the Mailman School of Public Health, has provided medical equipment totaling more than five million Emalengeni (more than $700,000) to Swaziland’s Ministry of Health. The equipment includes park homes, medical supplies, and furniture to support the scale-up of HIV care and treatment programs throughout the country.

The handover came after ICAP's Global Director Wafaa El-Sadr, MD, MPH, Mailman School Professor of Epidemiology, delivered a keynote address at the National Health Research Conference in Swaziland. During her talk on “HIV Treatment as Prevention,” Dr. El-Sadr discussed the recent scale-up of HIV treatment in low-resource settings and the potential effect of this scale-up on HIV transmission. She highlighted the importance of expanding HIV testing, linking all HIV-infected patients to HIV care programs, and supporting patients who begin antiretroviral therapy in their efforts to achieve high adherence rates. Approximately 200 individuals attended the session, which was also attended by Swazi Prime Minister Sibusiso Dlamini, and Minister of Health Benedict Xaba.

“With the highest HIV prevalence rate in the world, Swaziland has made substantial progress in confronting the epidemic and demonstrated commitment and leadership. The transfer of key equipment and vehicles to the Government of Swaziland will assist in furthering the government’s goals and plans,” said Dr. El-Sadr. “We hope the equipment ICAP is providing will help continue and expand critical HIV services here.”

At the conclusion of her talk, Dr. El-Sadr took an opportunity to thank USAID for their support of the ICAP program from 2006 – 2010.  She noted that while the USAID program ended, much work remains. With continued generous support from PEPFAR and the Centers for Disease Control, ICAP will continue to work hand-in-hand with the Swazi government toward achieving the goals of the national strategic framework and PEPFAR’s partnership framework.

Currently, ICAP provides technical support, onsite mentoring, and supportive supervision to 49 Swazi health facilities, including hospitals, health centers, and clinics. These sites have provided HIV care and treatment to more than 56,000 patients. In 2011, ICAP plans to expand its support for HIV services to a total of 55 hospitals and clinics throughout Swaziland, including  programs within the corrections system.

February 1, 2011