Ten years ago, people said it was not possible to treat HIV/AIDS in Africa. Today, millions of lives have been saved all over the world, including in the hardest hit countries, thanks to antiretroviral treatment. But the fight is far from over.

In Khayelitsha, a vast township on the outskirts of Cape Town with more than 500,000 inhabitants, nearly one adult in three is HIV positive. Throughout South Africa, the regional epicentre of the epidemic, a staggering 5,7 million people live with HIV/AIDS - more than in any other country in the world.

Here in Khayelitsha it is painfully clear that the global HIV/AIDS emergency is not over. Worldwide, 33 million people live with the disease that continues to wipe out two million lives a year. 6 million people in sub-Saharan Africa are in need of antiretroviral treatment, while only 30 % have access to the life-saving drugs they need, either because they are too expensive, because they are simply not available, or because donor funded treatment is waning. Time is running out for the nine million people worldwide in need of treatment. Without care, most people with HIV will die within three years.

Since pioneering HIV/AIDS treatment in Khayelitsha ten years ago, Médecins Sans Frontières (MSF), in collaboration with the South African Department of Health, has put almost 15,000 patients on antiretroviral treatment and developed effective and innovative ways to fight the epidemic. By integrating HIV and tuberculosis (TB) treatment, supporting patients on long-term treatment through adherence groups and by training nurses to provide HIV care, more and more patients in Khayelitsha can receive high-quality treatment and live healthy and positive lives. 

Thanks to massive international funding mobilised in recent years an estimated 4 million people are on life-saving antiretroviral treatment worldwide. And, as in Khayelitsha, much has been done to tackle HIV globally over the last decade. But now there are worrying signs that international donors are pulling back from their commitment to ensure universal access to HIV treatment, leaving million of patients in need. This donor retreat and the HIV/AIDS funding deficit threatens to wipe out the gains in treatment over the last decade, while less than half of people in need of antiretroviral treatment have access to it.