PEPFAR Office Director

HIV remains the greatest public health and socio-economic development challenge for Eswatini. While the data suggest that the rate of new infections is stabilizing, at 27% adult prevalence, Eswatini continues to shoulder the world's highest HIV burden. The country's epidemic is highly generalized with insignificant regional differences and only slight variances between urban and rural populations. An estimated 207,000 people live with HIV in Eswatini. Eswatini's HIV epidemic shows a stark gender differential, with women carrying the largest burden of disease. Eswatini also has the highest HIV-TB and HIV-cervical cancer co-infection rate in the world. Gender-based inequalities, violence, poverty and income disparities persist in the country and create significant barriers to effective HIV prevention interventions and the up-take of care and treatment services. Economic growth and development have been deeply impacted by the health crisis. In contrast to the growth take-off experienced by many Sub-Saharan countries, Eswatini has consistently ranked among the lowest in terms of economic growth in the region in recent years.