According to the Centers for Disease Control and Prevention (CDC), people living with HIV are at higher risk of smoking consequences than persons without HIV. Eswatini has put efforts in place to curb smoking in the country such as restriction of smoking in designated areas, prohibition of tobacco advertising and promotion, restrictions on tobacco packaging and labelling, but there is a dearth of literature to provide evidence on available smoking cessation programs in the country. This study aims to review and analyze the current state of smoking cessation programs in the country particularly for people living with HIV, and provide recommendations for a smoking cessation and tobacco harm reduction framework for persons living with HIV. Official documents including the National Multisectoral HIV and AIDS Strategic Framework (2018 - 2023) and the Eswatini Integrated HIV Management Guidelines (2022) provide recommendations for the screening of lifestyle factors including smoking and advice for quitting. However, sufficient light is not shed on the processes for caring for PLHIV who also smoke. The study concludes that smoking cessation and harm reduction programs for persons who smoke have not been effectively incorporated into national guidelines and programs for persons living with HIV, and thus the development of a prototype framework to guide healthcare professionals in delivering care for PLHIV who smoke across the different care models for ART delivery, including the use of Safer Nicotine products (SNPs) when necessary, can be discussed in the review of national HIV care documents.

The soaring brain drain in the healthcare sector constitutes a pressing and formidable threat to public health in third-world countries. The increasing interconnectedness of the world has facilitated sharing of ideas and collaborations across borders, benefiting the global population. However, this has also led to the migration of skilled healthcare professionals from low-income countries to more developed nations. This is due to push factors such as the lack of proper healthcare infrastructure, low income, poor working conditions, and limited career opportunities which push healthcare workers to seek better prospects in more developed countries. Pull factors such as better remuneration, working conditions, and career advancement entice them to migrate to these countries. Consequently, the delivery of adequate healthcare services becomes severely compromised, exacerbating existing challenges in achieving public health goals. The impact of this phenomenon extends beyond mere workforce loss. It stifles local education, hinders advancements in medical research, and undermines the overall capacity to combat prevalent health issues. Urgent action is imperative to address this silent crisis. By prioritizing the improvement of domestic healthcare systems, offering competitive incentives for healthcare professionals, and fostering international collaboration, we can effectively mitigate brain drain and strengthen the foundation of public health in third-world countries. This Paper aims to identify the drivers behind brain drain, highlight implications for public health and proffer potential solutions and actionable plans to address this growing concern.