[ESWATINI] Simultaneous outbreaks of pink eye, hand, foot and mouth disease, and seasonal influenza, plus the risk of mpox, have raised alarm in Eswatini, as US funding cuts cast doubt over the country’s capacity to handle multiple disease threats.

Eswatini’s ministry of health says it is operating in “Alert Mode” to encourage vigilance and early intervention, but local organisations say government responses are inconsistent and there is limited support for vulnerable communities.

An outbreak of mpox in neighbouring South Africa in March raised fears that the disease could spread across the border, while cases of flu and pink eye, or conjunctivitis, have surged in Eswatini itself, according to health authorities.

“Over the years, we have known of seasonal influenza and pink eye but mpox is a new concern for us.” ”
Cedric Chirwa, president of the Eswatini Schools Committee and Parents Association

“We have known of seasonal influenza and pink eye, but mpox is a new concern for us,” said Cedric Chirwa, president of the Eswatini Schools Committee and Parents Association (ESCAPA).

“We know little of it apart from what we hear from neighbouring countries.”

Chirwa, who has two school-aged children, said he had tried to implement preventative hygiene measures at home following public health announcements.

But he lamented: “Sanitisers aren’t cheap anymore like they used to be before COVID. The costs of this places much financial strain on rural families.”

Attempts by the health ministry to communicate public health messages to communities have fallen short, according to Chirwa.

“It’s business as usual here,” he added.

“People behave as if there is no outbreak.”

Thandiwe Dlamini, an elderly caregiver raising five orphaned grandchildren, highlights a shortage of medicines for those affected by the outbreaks.

“Winter is approaching and I am really worried for my grandchildren,” she said, adding: “There are no drugs when we really need them.”

Misinformation and myths

Medical professionals have observed a sharp increase in seasonal illnesses and voiced concerns about misinformation and under-resourced clinics.

Mduduzi Mbuyisa, a medical doctor with The Luke Commission healthcare charity who works closely with rural communities on disease prevention and health education, told SciDev.Net: “The surge in illnesses has led to heightened anxiety within our communities, resulting in a strong demand for accurate information.

“While some community members actively seek out this information, others remain sceptical of the health messages being shared.”

He added: “One of our primary challenges is combating misinformation while ensuring that there are sufficient resources available for testing, vaccination, and treatment.”

Mbuyisa warns that public facilities may lack the means to respond effectively and says harmful beliefs are taking root.

“Public facilities may have inadequate resources and costs can be prohibitive for low-income communities,” he explained.

“Additionally, there are troubling myths circulating, such as the belief that these diseases are man-made to coerce people into vaccination, or that vaccines are somehow malevolent.”

Funding cuts bite

It comes as the recent withdrawal of USAID support leaves major gaps in Eswatini’s health infrastructure, including workforce capacity and access to essential medicines.

“Funding cuts have left many questioning the capacity of local health authorities to respond effectively to health crises,” said Mbuyisa.

He says his team is educating the public on disease prevention practices such as handwashing and isolating the sick, but that a more coordinated public health campaign is urgently needed.

“Moving forward, we must enhance our communication strategies,” he added.

“This includes organising roadshows, distributing pamphlets, leveraging social media for awareness, and improving access to healthcare resources in public health facilities.”

Adman Shabangu, public health senior medical officer at Eswatini’s ministry of health, told SciDev.Net: “We are committed to informing the public, but we need families to actively engage in these health practices.”

Communications officer Nsindiso Tsabedze said the ministry was issuing press statements and using social media to disseminate important health information.

The ministry has confirmed an outbreak of hand, foot and mouth disease in the Manzini region, mainly affecting children, as part of its ongoing disease surveillance efforts.

Mpox has been confirmed in several Southern African countries, including South Africa and the Democratic Republic of Congo.

Tsabedze and Shabangu say there are no specific statistics on the prevalence of disease outbreaks in Eswatini. The lack of data, they say, makes it harder to allocate resources or anticipate community needs as the cold season sets in.

Community members say the absence of clear numbers is also fuelling confusion and mistrust.

“The absence of this data makes it more difficult to respond on a population health level,” Mbuyisa said.

“It places families in a state of vulnerability and anxiety, particularly as the winter season approaches, a time of year when respiratory illnesses become more common.”

The World Health Organization has called on African nations to boost their outbreak surveillance capacity and ensure that accurate, real-time data drives national response plans.

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.