When His Majesty King Mswati III ascended the throne in 1986, Eswatini was on the brink of one of the most severe public health crises in the African history. Coincidentally, in the same year, Eswatini identified the first HIV positive person, a development that marked the beginning of a pandemic that would profoundly test the nation’s resolve. By the mid‑1990s, Eswatini faced what would become the world’s highest HIV prevalence, with early projections warning of collapsing life expectancy and the possibility of negative population growth. As the epidemic intensified, the Kingdom required bold leadership to galvanize a national response—and His Majesty played a central role in steering that shift.
A defining moment in His Majesty’s leadership was the bold declaration of HIV as a national disaster in 1999. He made the call through a slogan that “HIV Yindzaba Yetfu Sonkhe”, loosely translated as “HIV is an agenda for all”. Through this declaration, His Majesty did not only recognise HIV as a national emergency, but a crisis affecting the country’s people, economy, families, and the future. The declaration mobilised the whole nation and government to act urgently, prioritising HIV in national policies, budgets, and development plans. It attracted international attention and support, leading to increased funding, partnerships, and programmes for prevention, treatment, and care.
It demonstrated His Majesty’s courage and visionary leadership, because at that time many leaders were still reluctant to speak openly about HIV due to stigma and fear. In response His Majesty’s call, by year 2000 at least 16 NGOs were providing HIV and AIDS services in the country in addition to the Ministry of Health (Eswatini National AIDS Programme, which was established in 1987). Subsequent to the declaration of HIV and AIDS as a national disaster by His Majesty, a Crisis Management Committee on HIV and AIDS headed by Ms Cristabel Motsa was established.
The King further declared HIV as an emergency in 2002 which resulted in the establishment of NERCHA, a state-owned entity, in 2003. NERCHA’s establishment created a strong multisectoral coordinating mechanism to lead, harmonise, and accelerate the national HIV response. Through this institutional leadership framework, Eswatini strengthened policy direction, partner coordination, accountability, and evidence-based programming across all sectors of society. The establishment of NERCHA aligned with the “Three Ones” principle, a UNAIDS framework which requires one agreed HIV and AIDS Framework, One National AIDS Coordinating Authority, and One Agreed Country-level Monitoring and Evaluation System.
As the national HIV response matured, His Majesty continued to use national platforms to draw attention to the social and structural factors fuelling new HIV infections. In 2015 during His speech from the throne, His Majesty emphasized the need to address drivers of HIV; including stigma and discrimination. He further, highlighted a policy statement – “Lokukhombana akuphele kutsi nya Maswati” – loosely translated as “stigma and discrimination must come to an end”.
His Majesty’s 2015 pronouncement envisioning a First World Status for Eswatini not only marked a pivotal moment in the country’s developmental discourse, it further fuelled the country’s HIV response as it was in line with the global HIV and AIDS targets on ending AIDS as a public health threat by 2030. His Majesty King Mswati III made a rallying call to the nation to pull out all stops to ensure that the Kingdom of Eswatini fulfils its commitment to End AIDS as a public health threat by the year 2022 widely known as Vision 2022.
The result of this rallying call by His Majesty was the introduction of test and start intervention which revolutionised the country’s HIV response. The country transitioned to a “Test and Start” model where anyone diagnosed with HIV was immediately eligible for treatment regardless of CD4 count. It was under His Majesty’s inspiring leadership that the nation mobilised across all sectors to confront the epidemic with resolve and resilience. His Majesty’s Government’s resolute commitment to the national HIV response ensured that lifesaving antiretroviral medicines were reliably procured through government resources, demonstrating the nation’s resolve to safeguard the health and dignity of all Emaswati. This achievement stands not only as a testament to His Majesty’s enduring vision, but also as a reflection of a nation that continues to rise above adversity through collective effort and unwavering leadership.
Commitment by His Majesty’s Government to the HIV agenda further resulted in the establishment of a Parliament Sessional and Portfolio Committee providing oversight on HIV and AIDS policy and guidelines. Under His Majety’s leadership, the Government of Eswatini established the Public Sector HIV and AIDS Coordinating Committee (PHSHACC) responsible for coordination and implementation of services targeting civil servants within Government. His Majesty’s Government also created a conducive environment for civil society, private sector, the traditional sector, the church, and development partners to jointly fight HIV and AIDS.
Post Vision 2022, His Majesty further inspired the nation with the powerful declaration in His Speech from the Throne in 2023, “Sicondzene Ngco ne-AIDS Asiyesabi” (Focus on the fight, not the fright), breaking stigma and mobilising communities, traditional leadership, government, civil society, and the private sector into unified action. Under His guidance, Eswatini rapidly expanded access to life-saving antiretroviral therapy (ARVs), introduced innovative prevention strategies such as Pre-Exposure Prophylaxis (PrEP), and ensured that HIV prevention, testing, and treatment remained a consistent national priority, reinforced in many of His Majesty’s public addresses.
The King’s strong political stewardship also unlocked vital global partnerships and resources, including support from The Global Fund to Fight AIDS, Tuberculosis and Malaria and the President’s Emergency Plan for AIDS Relief (PEPFAR). These investments strengthened health systems, expanded treatment coverage, enhanced prevention efforts, and deepened community outreach, accelerating progress at an unprecedented scale. Today, Eswatini’s achievement of the UNAIDS 95–95–95 targets ahead of time and the first country in Africa to attain these targets, stands as a powerful testament to His Majesty’s leadership, vision, and accountability.
In December 2025, Eswatini was the first country in Africa to introduce Lenacapavir, the new twice-yearly long-acting injectable HIV prevention option. In January 2026, during the dispersal of Emabutfo (regiments), His Majesty King Mswati III once again demonstrated visionary leadership by urging the nation to embrace Lenacapavir (LEN PrEP) as a new and powerful option for HIV prevention. With characteristic clarity and compassion, His Majesty encouraged the nation to safeguard its future by adopting this modern prevention option, affirming that medical innovation, when paired with responsible behaviour and traditional values, holds the power to strengthen the health and resilience of the Kingdom of Eswatini. This historic endorsement marked a new chapter in Eswatini’s journey towards ending HIV as a public health threat.
As we reflect on the Ruby Jubilee of His Majesty’s Coronation, his leadership in the HIV response stands out as a testament to his compassion and foresight. His tireless advocacy and commitment have not only saved countless lives, families, and a nation transformed but also set an example for future generations. As we celebrate His Majesty’s legacy, we are reminded of the power of compassionate leadership in driving meaningful change and fostering a healthier, more equitable world for all. NERCHA, proudly honours His Majesty’s pivotal role in shaping a coordinated, resilient, and people-centred HIV response. As NERCHA, we reaffirm our commitment to advancing the King’s vision of a healthy, empowered, and HIV-free Eswatini for generations to come.
BAYETHE! Wena Waphakathi!
Long live your Majesty!
