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November 28, 2012

MSF Pioneers Innovative Treatment for S. African AIDS Patients

by Anita Powell

South Africa has the world’s highest percentage of HIV-positive people, and runs one of the world’s largest programs to provide free AIDS drugs.  But many of those people say they want to manage their medication without visiting a hospital every few months.  Medical aid group Doctors Without Borders has pioneered a program bringing medications to the patients through special, home-based clubs.  

For Andile Madondile getting his lifesaving AIDS medicines used to mean taking a day off work every few months.  He would take public transportation to a busy government hospital, where he would often have to wait all day for his free medication.

It was expensive, time-consuming and, says the upbeat 33-year-old, it was depressing.

Today, Madondile is part of a pilot program by Doctors Without Borders that aims to help AIDS patients who are relatively healthy and effectively managing the disease.

Madondile, who works for the Cape Town-based Treatment Action Campaign, an AIDS advocacy group, has been taking antiretroviral treatment since his diagnosis in 2004.  He says the treatment is working: his viral load is low and his CD4 cell count is high.  His wife is HIV-negative. 

“We do not need to go, because we are not sick any more now," Madonile explains.  "We do not need now to go to the hospital, to wake up early in the morning - because we are using a public hospital - to wake up early in the morning and come back home late ...  So for us , it is very good, it helps us a lot.”

The concept is simple: every two months, nine people gather at Madondile’s house in Cape Town’s Khayelitsha township.  Madondile distributes everyone’s medication.  The group talks about health and related issues, like sex, nutrition, and living with AIDS.  After about half an hour, they go their separate ways.

The club, he says, is not for everyone.  He says he has been deluged with membership requests, but that the club only admits patients who have shown an ability to maintain their health.  They have to have an undetectable viral load and have spent a year on antiretroviral medication.

He also notes that running a club requires some knowledge: the club administrator has to arrange for  pickup or delivery of the medication, prepare it for use and help monitor club members’ health.

Doctors Without Borders, which goes by its French acronym MSF, has established more than 400 clubs in the past year in the Cape Town area, and demand is growing.

MSF Project Coordinator in Khayelitsha Lynne Wilkinson says the clubs are an option for AIDS patients who want to get on with their lives.  The clubs also allow medical professionals to focus on more serious cases in the hospitals.

Wilkinson also says the clubs address the non-physical aspects of the disease.

“Being HIV-positive has a whole range of impacts on an individual, particularly psychosocially, accepting their status, accepting how it is going to feature in their lives, concern of whether they are going to be able to be well long-term, and those are all issues that are much better addressed by a peer support environment rather than just sitting across the table with a clinician,” she notes.

The aid group could not immediately say how many of South Africa’s 5.4 million AIDS patients are healthy enough to participate in such clubs.