The Kingdom of Eswatini (in short form, Eswatini) is a small country almost completely surrounded by South Africa. Due in large part to its geographic position, the economy is heavily dependent upon trade with South Africa. The country has a relatively high per capita income, but nearly 70 percent of the population lives in poverty. Most high-level economic activity is conducted by non-Africans living in Eswatini. Primary education is widespread among boys and girls. The government’s transition from absolute to constitutional monarchy has been slow and remains incomplete. With the highest rate of HIV infection in the world – 26 percent of adults – Eswatini is facing a staggering pandemic. Tuberculosis is also at crisis levels. This health situation has brought overall life expectancy below 50 years, leaving an estimated 130,000 children without parents or adequate support. 

The majority of USAID’s work is in Eswatini is related to the President’s Emergency Plan for HIV/AIDS Relief (PEPFAR) program. Other programs managed out of USAID's Southern Africa regional office in Pretoria include a democracy and governance activity focusing on judicial independence and human rights, and an economic growth activity that reduces obstacles to foreign investment to expand the textile and garment industry. 

In a diplomatic note sent on May 18, 2018, the Swaziland Ministry of Foreign Affairs and International Cooperation requested that the United States Government change the name of the country from ‘Swaziland’ to ‘The Kingdom of Eswatini’. The U.S. Board on Geographic Names approved the change on May 25, 2018.