In 2009 the new South African government completely reversed its stance on one of the country’s biggest health challenges, and is now addressing HIV/AIDS and tuberculosis (TB) as major health priorities. On World AIDS Day, President Jacob Zuma announced a number of long-awaited changes to strategies on HIV/AIDS treatment, including the use of higher-quality drugs for initial treatment, and a new model of care to address the deadly HIV/TB co-infection directly. Médecins Sans Frontières has been continuing to provide HIV/AIDS and TB care to those in Khayelitsha and healthcare to refugees from Zimbabwe.

Khayelitsha, a township on the outskirts of Cape Town, is home to half a million people and has one of the highest incidences of HIV/AIDS in the country. Since May 2001, Médecins Sans Frontières has been running a program there in partnership with local health authorities offering antiretroviral therapy (ART). By December 2009, more than 13,550 patients were benefiting from the service.

But challenges remain including the lack of specific HIV/AIDS medication to treat children and adolescents, and the need for further integration of HIV/TB treatment to cope with the high numbers of patients who are co-infected. There are also increasing numbers of people being diagnosed with drug-resistant TB (DR-TB). Médecins Sans Frontières hosts a pilot project in the country offering DR-TB treatment through regular health centre visits, rather than in specialised isolation hospitals. The program has enrolled 582 patients in the last three years.

Médecins Sans Frontières has been continuing its work in central Johannesburg and in Musina, a town on the border with Zimbabwe, to provide Zimbabweans seeking refuge in South Africa with medical care and mental health services. In 2009, Médecins Sans Frontières also made regular mobile healthcare clinics available to the farms along the border where many migrants work. In these two projects, we treated more than 5,000 Zimbabweans a month, mainly for respiratory tract infections, sexually transmitted infections, gastrointestinal conditions and stress-related ailments. Almost 4,000 HIV tests were carried out across the two projects.

Médecins Sans Frontières has worked in South Africa since 1999.