The programme of Médecins Sans Frontières (MSF) in Chiradzulu District, Malawi, has demonstrated the value and feasibility of antiretroviral therapy (ART) in a poor rural context. Some 2194 patients were receiving ART in March 2004 and the clinical results were comparable to those found in developed countries.
Although the Chiradzulu programme is still evolving and the treatment systems and point of care are still being modified, the project already shows that, when treatment is adapted to local conditions and adequately supported by human and financial resources, comprehensive HIV/AIDS care, can be effectively provided in a rural setting. The Chiradzulu programme is one of MSF’s largest.
MSF currently provides ARV drugs to more than 13 000 patients in 56 projects and 25 countries. These projects provide a continuum of care, including prevention efforts (health education and the prevention of mother-to-child transmission of HIV), voluntary counselling and testing, the treatment and prevention of opportunistic infections, ART and psychosocial support.
The present case study outlines the ways in which MSF and the Ministry of Health and Population (MOHP) have sought to simplify treatment and diagnosis and to modify the delivery of care in order to increase the number of patients benefiting from ARV treatment.
This pilot experience demonstrates how ART can prolong the lives of patients in resourcepoor settings.
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