South Africa

The South African HIV/AIDS pandemic saw life expectancy in the country fall by ten years between 1992 and 2005, largely due to the failure of the national government to take steps in addressing the problem.

Since 2012, as part of its outreach testing services, MSF has annually performed thousands of HIV tests in over 30 high schools. This has not only increased HIV testing coverage in the district, but also demonstrated the feasibility of delivering sexual and reproductive health services on school grounds.

MSF’s project in KwaZulu-Natal province utilises community-oriented strategies to reduce the incidence of diseases and mortality, and to increase integrated HIV testing and tuberculosis (TB) screening, as well as access and adherence to HIV treatment.

MSF initiatives to decentralise drug resistant tuberculosis (DR-TB) care are underway in King Cetshwayo district, and allow patients to receive treatment closer to home.

The Khayelitsha project near Cape Town continues to develop innovative interventions in HIV and DR-TB care, with the aim of influencing local, national, regional and international policies on treatment for these diseases.

Sexual and Gender-based Violence

MSF continues to advocate increased access to comprehensive services at healthcare facilities for victims of sexual violence nationwide. A report, Untreated Violence: Critical gaps in medical and clinical forensic care for survivors of sexual violence in South Africa, publicised the findings of MSF’s telephone survey of facilities designated across the country to provide care for victims of sexual violence. The survey found that 73% of participating facilities do not provide or do not have the capacity to offer all necessary services.

MSF is calling for the inclusion of ambitious targets for increasing access for survivors of sexual violence to medical and psychosocial services at health facilities. Key interventions include providing post-exposure prophylaxis (PEP) to prevent HIV and other sexually transmitted infections, psychosocial support including trauma counselling, emergency contraception, other basic medical services (e.g. first-aid), and the option of forensic examination.

Alongside increased access to services there is also a need for health promotion within communities, as half of the women MSF surveyed in 2015 did not know that HIV can be prevented after rape if PEP is received within 72 hours.