Donor funding cuts hit hard in eSwatini

Crisis for people living with HIV as prevention services are affected by the pause on the US President's Emergency Plan for Aids in the country

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Nompilo Mdluli and Simphiwe Matsebula, of eSwatini, have something in common. They were both born with HIV. They have been taking lifesaving antiretroviral treatment (ARVs) for many years to stay healthy.

Despite not having to worry about access to treatment for the most part of their lives, Mdluli, 29, and Matsebula, 26, are anxious about the country's HIV response, and are afraid for the future of people like them who rely on this treatment daily, after US government funding cuts for the country's HIV response in late January.

"I still have medication, but I have heard that other facilities are running out of stock ... We have a very high number of people living with HIV in eSwatini and being out of stock of this medicine will actually mean that a lot of people will be infected and face high viral loads and cause deaths," said Mdluli.

The US government provided 60% support for the country's HIV response through the President's Emergency Plan for Aids Relief (Pepfar), including the procurement of secondand third-line medicine.

People living with HIV did not have to worry about receiving their monthly treatment refill, sometimes for up to six months in advance for those whose viral load is suppressed or otherwise healthy. But this has now changed. While the country still has antiretroviral treatment stock, facilities can only dispense the medication on a monthly basis.

Adhering to daily treatment is important for people living with HIV, to ensure that they can live long, healthy lives and reduce the risk of transmitting the virus to others.

Matsebula and Mdluli are afraid that the availability of this lifesaving medicine may not be guaranteed for long in eSwatini.

"There was one hospital that was helping Amaswati for free with HIV services. It got shut down because of the lack of funds. They didn't have the money to continue with their services," Mdluli said.