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MSF in South Africa, 2004
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With approximately 5.3 million people infected with HIV, South Africa has the highest number of people living with HIV/AIDS of any country. In November 2003, the South African government approved a new national HIV/AIDS plan that added life-extending antiretroviral (ARV) therapy to the existing protocol and set a goal of treating 600,000 people with ARVs by 2008.
The government's revised HIV policy marked the start of an intensive effort to broaden the use of ARVs in Khayelitsha township, in the Western Cape province. MSF runs three HIV/AIDS clinics within primary health care centers in Khayelitsha. These clinics provide prevention information, HIV testing, counseling and management of opportunistic infections, as well as ARV treatment to people at advanced stages of AIDS. By July 2004, clinic doctors and nurses were conducting 150 to 200 medical consultations per day and providing ARVs to nearly 1,200 people. MSF's aim is for 2,000 people to be receiving ARVs by the end of 2004.
In collaboration with the Nelson Mandela Foundation, MSF operates a second rural HIV/AIDS program in Lusikisiki, in the Eastern Cape province, one of the country's poorest areas. The program has tested more than 600 people for the virus each month and has demonstrated an HIV-positive prevalence of 30 to 40 percent. MSF manages opportunistic infections in 11 rural clinics and in the district hospital and began offering ARV treatment in the clinics in November 2003.
In October 2003, MSF opened the Simelela Rape Survivors Center in Khayelitsha. The center offers medical and psychosocial care, including post-exposure prophylaxis to prevent HIV transmission, and trauma counseling. The center's staff conducts 25 to 35 consultations per month. More than half of the rape survivors treated are children younger than 14 years of age.
MSF continues to work in partnership with the Treatment Action Campaign to advocate for increased access to treatment. Together, the two groups support patients' adherence to treatment and community education about treatment options, promote the use of fixed-dose combinations of ARVs and monitor the impact on health of southern Africa's free trade negotiations with the United States.
MSF first worked in South Africa in the mid-1980s and returned in 1999 to respond to the needs of people affected by HIV/AIDS.