Since its discovery in 1981, HIV/AIDS has killed more than 25 million people. In most places with high HIV rates, like South Africa, Swaziland and Malawi, access to life-saving antiretroviral therapy (ART) has dramatically improved over the last decade. However, more than five million people in low- and middle-income countries still lack access to the ART medicines needed to treat HIV and AIDS. In addition, according to UNAIDS (Joint United Nations Programme on HIV/AIDS), one in four people who start HIV treatment in such countries do so dangerously late.

According to the World Health Organization, there are more than 34 million people living with HIV/AIDS worldwide, the majority of them in sub-Saharan Africa. South Africa is one of the largest and most populous countries in sub-Saharan Africa. The country has a generalized HIV epidemic, with a national antenatal prevalence of around 30% and a national prevalence rate of 17%, according to UNAIDS.

International aid agency Médecins Sans Frontières (MSF) surveyed more than 2,300 of South Africa’s 3,800 public health facilities and found that one in five had either run short or run out of drugs in the previous three months.

According to Treatment Action Campaign, a South African advocacy group that took part in the research, six out of the nine South African provinces surveyed reported that more than 17% of their facilities had shortages of essential drugs. Mpumalanga, Limpopo and the Free State fared the worst with an unacceptable 25.9%, 40.8% and 53.8% respectively.

Medicine shortages have led to patients taking partial doses of their treatment, or interrupting or defaulting on their treatment altogether. Possible consequences include drug resistance, decreasing immunity, increased risk of opportunistic infections and transmission of HIV, ultimately leading to more illness and death. Even more worryingly, in 20% of affected facilities patients were sent home or referred elsewhere without medicines.

Despite the findings the South African Health Ministry, although admitting that there are likely to be ‘some challenges’ when running a project as big as this, has dismissed the results as an ‘over-exaggeration’.

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