Africa-Press – Eswatini. The Kingdom of Eswatini secured the long-term sustainability of its health sector on 12 December 2025 with the signing of a E4 billion ($242 million) Memorandum of Understanding (MoU) with the United States government.
The five-year agreement, signed at the American Corner Mbabane, establishes a clear path for Eswatini to assume full national ownership of its globally successful HIV response and save countless lives.
The total funding package includes a significant contribution of up to E3.77 billion ($205 million) from the U.S. to strengthen priority health initiatives, particularly in HIV prevention and treatment. Crucially, the Government of Eswatini pledged to increase its own domestic health budget by E679 million ($37 million) over the same period, demonstrating a strong commitment to health self-reliance.
The MoU is designed to be a catalyst for a sustainable health system, building on over two decades of successful collaboration.
Minister of Health Mduduzi Matsebula described the agreement as launching a “new era of partnership,” stating that it “empowers us to fully lead the HIV response going forward” while maintaining high-quality care for citizens living with the virus.
U.S. Chargé d’Affaires Marc Weinstock affirmed the commitment, saying: “This MoU is more than a document, it is a shared commitment that reflects our mutual dedication to a healthier, more resilient future for both our nations. We look forward to continuing to save lives and strengthen health systems.”
The agreement outlines a strategic, phased transition to ensure that health gains are permanent and locally managed. This includes a critical Workforce Transition plan, where the financial responsibility for frontline health workers will gradually move from U.S. support to the Eswatini government’s payroll. Concurrently, the partnership will ensure the local supply of essential medical commodities, such as Antiretroviral Medications (ARVs). To guarantee a seamless shift and continuity of care, the U.S. government has committed to covering 100 percent of these costs, including both staff and supplies, for the first year of the MoU.
The United States will help Eswatini roll out innovative health solutions, including the newly introduced lenacapavir, a cutting-edge HIV prevention injection that only needs to be administered twice a year. This breakthrough offers a powerful new tool to protect thousands of Emaswati, strengthening the country’s fight against HIV and providing hope for a healthier future.
Funding will be directed towards upgrading Eswatini’s public health data systems, laboratory diagnostics, and monitoring capabilities. This crucial investment will enhance the country’s ability to track health trends, respond swiftly to disease outbreaks, and address other emerging public health threats, ensuring a stronger and more resilient healthcare system.
Minister of Economic Planning and Development Dr. Tambo Gina hailed the agreement as a “milestone” in the nation’s journey, one that strengthens Eswatini’s ability to manage infectious diseases and safeguards the wellbeing of its citizens.
This signing reinforces the bond between the two nations, which, since 2003, has seen the U.S. invest more than E16.5 billion (over $900 million), successfully transforming Eswatini’s health sector and laying the foundation for the nation to finance and steer its own health agenda.
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