Malawi: HIV/AIDS programs overcome cultural taboos

As a result of the AIDS epidemic, life expectancy in Malawi has fallen to 41 years. Since 1990, MSF has provided integrated HIV/AIDS care, including voluntary counseling and testing, programs to prevent mother-to-child transmission of the virus, treatment of opportunistic infections, and education. In summer 2001, MSF began treatment with antiretroviral (ARV) medicines (see page 89 for more on MSF's ARV projects around the world). Pilot antiretroviral program MSF launched a pilot antiretroviral treatment program in the rural district of Chiradzulu in August 2001. By June 2002, over 140 people were receiving these life-extending medicines. Together with the local community, MSF has created an admissions committee to participate in decisions regarding access to the program. By fall 2002, 70 new patients are to be included in the program each month. The program will also be extended to children. An integrated approach to HIV/AIDS in Thyolo Home-based AIDS care continues in the southern district of Thyolo, where MSF has an integrated, multi-sector program that includes education and prevention in high-risk groups and treatment of related diseases. MSF treats approximately 300 tuberculosis patients per year in Malawi and over 75% are also HIV-positive. In March 2002, MSF expanded the program in Thyolo to include prevention of mother-to-child transmission of HIV. This program provided prenatal counseling for more than 800 women in its first month, with 90% accepting voluntary testing for HIV, an extraordinary number in a country where HIV/AIDS is not discussed openly. Cholera epidemic Beginning in November 2001, MSF also responded to a cholera epidemic that swept Malawi. Under control by March 2002, the epidemic resulted in over 20,000 cases. MSF is also monitoring the nutritional situation in Malawi. The first MSF project in Malawi took place in 1986. International staff: 13 National staff: 94