South Africa

MSF study shows cryptococcal meningitis as leading cause of death, but access to best treatment is a major challenge

Without appropriate funding, the opportunity to reap the benefits of new science showing that HIV treatment both saves lives and helps prevent new infections could be lost.

Not long ago, it was tempting to think the battle against measles was being won. Stepped-up vaccination campaigns had driven the number of reported cases down to 32,000 in 2007, according to the World Health Organization, the lowest ever recorded. Over the past three years, however, there has been a resurgence.

In early June, world leaders and global health officials gathered at the United Nations for a summit meeting on HIV/AIDS. Among the outcomes was a new treatment target, a plan to get 15 million people living with HIV/AIDS on antiretroviral (ARV) treatment by the year 2015.

To highlight the critical humanitarian and medical needs that exist in urban settings the world over, MSF presents "Urban Survivors," a multimedia project produced in collaboration with the NOOR photo agency and Darjeeling Productions.

As the Measles Initiative meets in Washington, D.C., MSF is calling for an effective outbreak response mechanism to be established immediately to deal with the rising numbers of severe outbreaks worldwide. 

While several countries hardest hit by HIV/AIDS are improving treatment protocols to reduce deaths and illness, a lack of donor support still prevents many from implementing vital changes.

A promising new test will finally help detect more people with drug-resistant tuberculosis, a development that lends greater urgency to solve major problems surrounding the pricing and supply of DR-TB medicines

HIV/AIDS treatment in developing countries is being dealt a double blow that will mean treatment recommendations cannot be implemented and the promise of new scientific research will remain unfulfilled.

In South Africa, where the FIFA World Cup is getting under way, MSF is trying to show that beating HIV/AIDS should be the ultimate goal.

Malawi has been facing its biggest measles epidemic in 13 years. Working with the local health authorities, MSF has launched a vaccination campaign for more than 2.5 million children.

Johanesburg/New York, May 27, 2010 - Backtracking by international donors of HIV/AIDS treatment risks undermining years of positive achievements and will cause many more unnecessary deaths, warned the medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) in a new report released today.

In June 2009, Doctors Without Borders/Médecins Sans Frontières (MSF) released a report, No Refuge, Access Denied, which outlined the severe risks Zimbabweans took in order to cross the border, the dangerous conditions under which they lived once they reached South Africa, and their lackof access to health care.

MSF is expressing grave concern for the health and lives of thousands of survival migrants and refugees entering and living in South Africa. Sexual violence, appalling living conditions, police harassment, threats of xenophobic attacks, and a lack of access to essential health care still define the desperate lives of thousands of these vulnerable people.

Eric Goemaere hopes the patent pool will work out so he doesn't have to watch his patients in Khayelitsha die. In the U.S. HIV patients have a 69-year life expectancy. But his patients in Khayelitsha are running out of options after only 8 years on therapy. "I don't accept the principle of double standards," he says. "If it's possible to get 69 years of life in the U.S., it should be possible to get something comparable in South Africa."

Today, the good news is that four million HIV-positive people are alive on antiretroviral therapy (ART). The bad news is that MSF teams working to treat HIV/AIDS are witnessing worrying signs of waning international support to combat HIV/AIDS.

With a dire need for newer medications, a shortfall in funding and no increases on the horizon, the AIDS emergency in the developing world is far from over. Doctors Without Borders/Médecins Sans Frontières (MSF) spoke out at the International AIDS Society Conference held in July in Cape Town, South Africa, to push for urgent action.

The Simelela center was set up to offer medical care, the collection of forensic evidence, counseling and follow-up care for victims of sexual violence in the rape-ravaged township of Khayelitsha.

“We did a lot of work to raise awareness. We went door-to-door, held marches, and put on puppet shows for children at schools and crèches. We told them, ‘Speak up and break the silence about rape’. Married women or girlfriends who had been imprisoned in their own bedrooms told us what happened to them."

Busisiwe Beko, a gregarious community health worker for MSF, set out on foot into Khayelitsha, a vast township of 500,000 people in South Africa, to hunt for one particular ailing young woman.

Cape Town, July 20, 2009 – Stagnation in HIV/AIDS funding and the high cost of new medicines are putting the lives of thousands of poor patients at risk, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) warned today at the 2009 International AIDS Society conference in South Africa . Patients needing new drug regimens will return to AIDS “death row.” While the lack of access to antiretroviral treatment for seven million people remains unaddressed, inadequate financing now further threatens treatment scale-up.

Over three million people living with HIV/AIDS in the developing world receive antiretroviral therapy (ART). However, the medicines and diagnostic tools available are inadequate to respond fully to their needs. In addition, seven million people are in need of treatment and are still waiting for access.

Despite the fact that many Zimbabweans risk their lives to flee Zimbabwe, the South African government has historically characterized them as ‘voluntary economic migrants’ and aggressively deported them. Until recently, approximately 17,000 Zimbabweans were deported each month by South African authorities, according to United Nations and South African Department of Home Affairs figures.

Johannesburg/Brussels/New York, June 2, 2009 – Violence, sexual abuse, harassment, appalling living conditions, and a serious lack of access to essential healthcare define the desperate lives of thousands of Zimbabweans in South Africa today, warned the international medical humanitarian aid organization, Doctors Without Borders/Médecins Sans Frontières (MSF).

Despite the fact that many Zimbabweans risk their lives to flee Zimbabwe, the South African government has historically characterised them as ‘voluntary economic migrants’ and aggressively deported them. Zimbabweans say they had little choice but to leave and thousands continue to cross the border every day, legally and illegally, as a matter of survival.

MSF's Head of Mission in South Africa speaks about the South African government's decision to close a refugee camp, which provides medical care, housing and food to thousands of Zimbabwean refugees.

I live in Khayelitsha, a large township on the outskirts of Cape Town. I grew up in Eastern Cape with my parents and four older brothers.

The levels of sexual violence in South Africa are alarming: it is estimated that a woman is raped every 26 seconds. Khayelitsha, a poor township on the outskirts of Cape Town, has one of the highest incidences of rape in the country. In Khayelitsha, survivors of sexual violence receive care at Simelela, a center offering comprehensive services that go far beyond basic medical needs in a unique partnership between MSF and numerous local partners.

As a result of its worst cholera epidemic in recent memory, Zimbabwe declared a national emergency in early December. Cholera rapidly spread throughout Zimbabwe’s provinces and then into neighboring countries, particularly South Africa. According to the South African Department of Health, there have been more than 900 suspected cases. Recently South African authorities in the northern province of Limpopo declared Vhembe district, which borders Zimbabwe, a disaster area.

Some of the world’s leading photojournalists worked alongside our medical teams throughout 2008, documenting our work and following the lives of our patients and their communities. At the same time, some of our own staff captured unforgettable moments that we are pleased to include in this Year in Pictures issue of Alert, which brings together some of the most moving and telling photographs of the crises to which we responded in 2008.

When violence aimed at foreign nationals broke out in Johannesburg and Cape Town, MSF provided medical assistance to people who sought refuge in police stations, community halls, and churches.

Brussels/Johannesburg/New York, June 28, 2008 — The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) today expressed alarm at the deportation of approximately 500 Zimbabweans, including women and children, from a detention center in Musina, South Africa, at the border with Zimbabwe.

One month ago, violence against foreign nationals in South Africa erupted in parts of Gauteng, Western Cape, and Kwa-Zulu Natal Province, leading to the displacement of more than 80,000 people across the country, according to the United Nations High Commissioner for Refugees (UNHCR). Initially, tens of thousands of people fled to police stations, community halls, churches, and mosques to seek shelter and safety. For three weeks, they lived in poor conditions and relied primarily on a patchwork of assistance from private individuals and organizations.

Johannesburg/New York, June 2, 2008 – The international medical humanitarian organization MSF today expressed alarm at the process of relocation imposed on people displaced by recent violence in Johannesburg, South Africa. After living in unacceptable conditions for up to three weeks, the people displaced are now being relocated by the South African government—without proper access to information about their rights and options—to sites that are unprepared and insecure.

In response to recent outbreaks of violence against migrants in Johannesburg, South Africa, MSF is currently providing emergency medical care for wounded people seeking shelter in police stations, community halls, and other locations to which they have fled for safety.

In December 2007, Doctors Without Borders/Médecins Sans Frontières (MSF) began providing essential health services to Zimbabwean migrants in the South African border town of Musina, Limpopo province, and in central Johannesburg. It is estimated that more than one million Zimbabweans live in South Africa.

New York,  November  29, 2006  - AIDS treatment in the developing world will not be sustainable unless international institutions get serious about the high cost of newer medicines, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) warned today.

Since May 2001, three HIV/AIDS clinics in the three day-hospitals in Khayelitsha have been offering antiretroviral therapy to people with AIDS who need treatment.

In Khayelitsha township, a poor area near Cape Town, Eric Goemaere, MD, head of MSF in South Africa, works with colleagues and local AIDS advocacy groups to bring antiretroviral (ARV) treatment to those who need it and to push the country's government to do much more.

It took coming to South Africa as an MSF volunteer for me to understand that the horror of apartheid had not disappeared. A new scourge, AIDS, had appeared in its place.