RONGAI KENYA, The clinical officer at Ray Drop-In Centre demonstrates the range of anti-retrovirals they can provide to clinic clients. (c) Nell Freeman for the Alliance
The Government is committed to provide ART to every population

The provision of treatment care and support services is one of the key mandates of the National ART unit under SNAP. The program has strived to provide universal access to HIV prevention, care, treatment and support services that are sustainable and of high quality.

Currently more than 80% of the public facilities are already accredited to provide ART services and more than 60% of the ART initiations in the country are done by nurses who have been trained on ART initiation. The decentralized services have been facilitated by the introduction of point of care CD4 machines that have been deployed in rural clinics and minimized the dependence on the National Sample Transport System, which i s already overwhelmed by the demands for sample pick-ups. Decentralization of HIV care and treatment services has also resulted in the improvement of ART coverage from 52% in 2008 to 84% in 2013.care

ACHIEVEMENTS
  1. Annual report 19 – 40
  2. Increasing numbers of people enrolled for Pre-ART care
  3. Development of SOPs, job aids and training of health workers on linkages to care
  4. Increase in facilities providing ART from 26 in 2008 to 133 in 2013 (SAM 2013)
  5. Increase in the average CD4 cell count at ART initiation from 8 in 2008 to 236 in 2013 and 282 in 2015
  6. Development and roll out of a curriculum on Nurse led ART initiation in Swaziland to facilitate decentralization of ART 100% procurement and provision of free ARVs by government.
  7. Coverage
  8. More Initiations
PRIORITY  ACTIVITIES FOR 2016/17
  1. Scale up of test and start from 1st October 2016 to all PLHIV in all health facilities
  2. Increase access to routine viral load monitoring.
  3. strengthening adherence and psychosocial systems to ensure that those with unsuppressed viral load receive appropriate care Conducting two HIV drug resistance survey from June 2016 results will be out in 2017;
  4. Pre-treatment HIVDR survey
  5. Acquired HIVDR survey (ADR 12 &ADR 48)
  6. Differentiated care – Rolling out new models of ART service delivery from June 2016
  7. Adapting WHO 2015 guidelines
  8. Conducting a second Swaziland HIV incidence measurement survey (SHIMS II).
  9. Scale up of community Expert clients to help educate communities about HIV services as well as link clients lost to care.
  10. link:   annual plan 2016 – 17
STRATEGIES AND PRIORITIES
Pre-ARTART
1. Intensify linkages between HTC and Pre-ART
2. Strengthen the comprehensive pre-ART package with a strong referral system and linkages to other HIV programmes
3. Reinforce the integration of gender sensitive Sexual and Reproductive Health (SRH) Services
1. Reinforce the referral system and tracking mechanisms for PLHIV on ART
2. Enhance integration of ART services with other health care services such as TB and SRH
3. Strengthen community systems to enhance quality and provision of HIV services for PLHIV including through continuation of nutrition support
4. Strengthen procurement and supply management for drugs and related commodities
5. Accelerate task shifting and capacity development of lower level health officers
6. Establish quality ART services in all health facilities 7. Develop the research capacity within the National ART