South Africa

Community Care Giver Nonhlanhla Ngema delivers anti-retrovirals to members of her Community ART Group in Sunnydale, Eshowe, a rural district of South Africa. CAG members meet once every two months to review their health and arrange for collection of their ARVs without having to sit in long queues at clinics.
SOUTH AFRICA 2016 © Greg Lomas
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This information is excerpted from MSF’s 2016 International Activity Report.

South Africa has the largest HIV patient cohort in the world and has helped to lead efforts to gain access to new treatments for multidrug-resistant tuberculosis (MDR-TB). In KwaZulu-Natal province, the Doctors Without Borders/Médecins Sans Frontières (MSF) HIV/TB project in Uthungulu district aims to be the first site in South Africa to meet the United Nations 90-90-90 targets, where 90 percent of all people living with HIV know their status, 90 percent are on antiretroviral (ARV) treatment, and 90 percent have reached the stage where the virus has been suppressed. In 2016, MSF tested 56,029 individuals, supported 2,370 male circumcisions, and distributed 1,573,756 condoms.

In partnership with the city and the organization mothers2mothers, MSF’s Khayelitsha project near Cape Town established 13 postnatal “Moms and Tots” clubs where women and their babies could get one-stop services for HIV and other health issues. MSF fought for access to new drugs for patients in Khayelitsha and nationally. South Africa now has national access to the new TB drug bedaquiline, and in Khayelitsha MSF had the largest national cohort on another promising new medication, delamanid, with 61 new patients initiated on treatment in 2016.

With the Department of Health in North West province, MSF expanded access to care for victims of sexual violence in Rustenburg, in the platinum mining belt. An MSF survey showed that one in four women in Bojanala district had been raped in their lifetime, and that half had experienced some form of sexual or intimate partner violence, but 95 percent had never told a health care worker.

MSF supported three Kgomotso health care facilities providing a package of medical, legal, and psychosocial care to victims of sexual violence—including a forensic examination, post-exposure prophylaxis (PEP) to prevent HIV and other sexually transmitted infections, and psychosocial support. In 2016, 290 survivors were treated.

MSF is a founding member of the Fix the Patent Laws coalition, 32 patient groups and organizations campaigning for reform of South Africa’s intellectual property laws to improve access to affordable medicines. Following years of pressure, the South African Department of Trade and Industry released a new intellectual policy consultative framework in 2016.

The Stop Stockouts Project, a civil society consortium supported by MSF and other organizations, monitors the availability of essential drugs in clinics across the country and pushes for the rapid resolution of stockouts and shortages. In 2016, the project received 605 reports of stockouts and trained 3,454 patients and activists.