MSF projects in South Africa and Lesotho
Since 2000 MSF has been working in South Africa, primarily in response to the HIV epidemic. In Khayelitsha, the largest township in the Western Cape, MSF has worked with the provincial authorities to pioneer comprehensive HIV treatment, including antiretroviral (ARV) medicines, at a primary care level. Today, these clinics support over 6,000 people on ARV therapy.
In 2003, together with the Nelson Mandela Foundation, MSF opened a similar programme in Lusikisiki, one of the most underserved areas of rural Eastern Cape. By 2005 universal ARV coverage had been achieved and in 2006 the programme was finally handed over to the provincial health authorities.
At the same time, MSF was opening a programme in Lesotho based on the model implemented in Lusikisiki. There, MSF and the health authorities started a pilot nurse-based programme to provide HIV/Aids and TB care. In less than two years, nearly 2,000 people had been initiated on ARV treatment.
Together, these programmes have done more than simply treat patients. They have provided vital lessons about how comprehensive treatment for HIV can practically be delivered both in rural and urban settings. At the same time, MSF has been lobbying, with many others, for cheaper medicines, more global funding for the HIV crisis and changes in policy towards the epidemic,
Despite the successes, many challenges remain, such as the problems of TB and HIV co-infection, drug-resistant strains of TB and the issue of long-term adherence to ARV treatment. MSF works with patients, academics, local health authorities and international experts to find innovative and practical solutions to these problems. In response to the high levels of sexual violence in Khayelitsha, MSF supports the Simelela centre for rape survivors – a one-stop location which combines practical medical care to protect against infection and psychological support with police and forensic assistance. MSF also keeps its capacity to react to new humanitarian needs arising in South Africa.
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