Swaziland, working to combat two concurrent epidemics of HIV and tuberculosis (TB), has recently intensified nationwide HIV testing and TB case finding campaigns. However, these efforts have been hampered by routine stock-outs of key TB, laboratory, HIV and AIDS, and other health commodities. In December 2011, 50% of tracer products were stocked out at the central level, while 23% of tracer products were stocked out at health facility warehouses. The challenge of maintaining a consistent supply of commodities threatens not only current efforts to help curb the HIV and TB epidemics, but may also erode the progress made to date toward advancing prevention, diagnosis, and treatment services. The rapid scale-up of these programs as well as fiscal challenges in the health sector, have exposed weaknesses related to procurement and supply chain systems.