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MSF in South Africa, 2012
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An estimated 5.6 million people are living with HIV in South Africa, the highest number of people in any country in the world. KwaZulu-Natal province has the highest HIV prevalence in the country, and Doctors Without Borders/Médecins Sans Frontières (MSF) has a programme in KwaZulu-Natal with ambitious aims to increase testing and treatment coverage and initiate treatment earlier. The team tested more than 23,000 people through its mobile one-stop shop in 2012, almost triple the number for 2011. This was in part a result of work with community leaders and traditional healers to gain acceptance for testing and treatment. The vast majority of the 2,000 patients enrolled in HIV care were started on antiretroviral (ARV ) treatment. In 2012, the South African Department of Health announced that it was shifting gradually to a single daily pill for HIV patients. It also announced that it will offer this same fixed-dose combination ARV treatment to all pregnant women throughout pregnancy and breastfeeding to prevent mother-to-child transmission of HIV. These two moves will make treatment easier for patients and simplify care.
Expansion of adherence clubs in Cape Town
Instead of attending one-to-one appointments at the health centre, adherence club members go to meetings every two months for a check-up and drug refill, and to talk to other patients. MSF’s analysis found that 97 percent of club members stayed in care, while the figure was 85 per cent for patients who qualified for club membership but remained in mainstream clinic care. By the end of the year, there were 180 clubs, with more than 4,500 members, at nine health facilities in Khayelitsha. The Western Cape Department of Health has also set up more than 400 clubs. Incidence of drug-resistant tuberculosis (DR-TB), a form of TB that demands two years of treatment, which can have painful side effects, is particularly high in Khayelitsha. Close to 200 patients, including those with multidrug-resistant TB and extensively drug-resistant TB, were started on treatment at their local clinic in 2012. This pilot project has contributed to changing South African health policy towards decentralised
At the end of 2012 MSF had 207 staff in South Africa. MSF started working in the country in 1999.