The Canadian Medical Association Journal (CMAJ) reports on HIV in the Kingdom of Swaziland, writing the country “now has the dubious distinction of having the world’s highest rate of both HIV and tuberculosis (TB).” The journal notes “[a]bout 26 percent of adults aged 15-49, or about 202,000 of all the citizens of Africa’s last absolute monarchy, are HIV-positive, according to the Swaziland government,” and asks, “Why are the 1.2 million people of this landlocked kingdom … in such dire straits?” CMAJ writes, “A host of underlying factors appear to be at the root of its woes: politics, history, culture, economics, poverty, gender inequity, and much more.”

According to the CMAJ, the country’s health system is “plagued by staffing shortages, as well as frequent shortages of laboratory supplies and antiretroviral” therapies (ARTs). However, “[w]hen the shortage of antiretrovirals became particularly acute in 2007, the government took the rather unusual step of inviting [Medecins Sans Frontieres’] aid,” the journal writes, adding, “Since partnering with numerous non-governmental organizations and the rapid rollout of ARTs, Swaziland’s HIV rates have stabilized, says Minister of Health Benedict Xabo.” CMAJ notes, “The emphasis now is on getting more people to testing, counseling and treatment, particularly pregnant women, ‘in order to ensure an HIV-free generation,’ adds Xabo” (Sibbald, 10/17).