the real virus killing eswatini is royalty

king mswati hoards wealth while nurses go unpaid. the americans funded hiv treatment but ignored the regime that made the virus worse

In February, patients arriving at Eswatini’s Miracle Campus found its gates closed. A written stop order from USAID had forced the facility to suspend nearly all services. For years, this U.S.-funded campus had quietly delivered critical healthcare to a significant share of the population. Some medications, like HIV and TB treatments, were still being dispensed through emergency donor support. But the broader system buckled. With U.S. funding gone, the illusion of a self-sustaining healthcare system collapsed.

An aerial view of the Luke Commission’s Miracle Campus in Eswatini. A sprawling U.S.-funded medical facility. Run by a Christian missionary organization, TLC became a key pillar of Eswatini’s aid-dependent health system, until February 2025, when the Trump administration cut USAID funding, forcing widespread service suspensions and exposing the system’s deep reliance on foreign aid.

This is not just a story of aid withdrawal. It is a story of how one of the world’s most repressive monarchies avoided building robust public institutions altogether and how the global aid industry helped it do so. The collapse of healthcare in Eswatini is not just a crisis of foreign policy. It is a crisis of domestic autocracy, donor complicity, and the politics of dependence.

Eswatini, a landlocked monarchy of approximately 1.2 million people, holds the highest HIV prevalence globally, with an estimated 25.9% of adults aged 15–49 living with the virus. This staggering figure results from a complex interplay of historical, social, economic, and structural factors. During the late 20th century, labor migration led many Swazi men to work in South African mines, separating them from their families and exposing them to high-risk behaviors . Coupled with a chronically under-resourced healthcare system, the virus spread rapidly through communities with limited access to testing or treatment .