With support from USAID through the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, MSH is strengthening local and regional systems to respond more effectively and sustainably to the HIV/AIDS epidemic in Swaziland. SIAPS interventions aim to strengthen governance in the pharmaceutical sector, increase capacity for pharmaceutical supply management and services, address information for decision making, and improve pharmaceutical service delivery.  

Project highlights include:

Medicine regulatory system: The legislation regulating medicines, pharmaceutical establishments, and the pharmacy profession in Swaziland was outdated and ineffective. SIAPS facilitated bills to establish the first ever Medicines Regulatory Authority (MRA) and the development of the 2012–2016 Pharmaceutical Strategic Plan to provide strategic direction for strengthening the pharmaceutical sector in Swaziland.

Human and institutional capacity development: The shortage of qualified pharmacy personnel was a major limitation in the country’s efforts to expand HIV/AIDS and TB treatment programs. SIAPS supported the MOH and other stakeholders to design the curriculum for the first pharmacy training program. This enabled the Southern Africa Nazarene University (SANU) to establish a Department of Pharmacy and launch the pharmacy assistants and technicians program. SIAPS also trained 1,148 service providers on pharmaceutical management.

Management of information systems for better patient care: There was limited organizational and human resource capacity to implement a logistic management information system (LMIS) to ensure an uninterrupted supply chain for ARVs. SIAPS worked with in-country partners to revamp the LMIS and improve the use of RxSolution and other electronic tools for inventory and patient management.

Availability of medicines: The rapid scale-up of HIV and TB treatment programs exposed weaknesses related to procurement and supply chain systems, indicated by frequent stock-outs of essential medicines. SIAPS supported the MOH to establish the Supply Chain Technical Working Group (TWG) to facilitate planning, procurement, and distribution to avoid both over- and under-stocking of key commodities.

Patient safey and treatment: To improve patient safety and promote adherence to HIV/TB treatment, SIAPS assisted the MOH to design interventions to address adverse drug reactions. From June 2013 to September 30, 2016, 4,210 patients were enrolled in an active surveillance system and 1,224 adverse drug events (ADEs) were reported. Of the enrolled patients, 76% were taking ARVs and 24% were taking anti-TB medicines.