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South Africa's health, humanitarian, and socio-economic problems are characterized by extreme inequalities and misdistribution of resources. Thirteen per cent of the population lives in "first world" conditions, while nearly 50% live in poverty, characterised by poor housing and limited access to basic services, such as water, sanitation, electricity and primary education. Worldwide, South Africa has the highest number of people living with HIV - at 6.8 million - and the largest antiretroviral therapy programme, the highest incidence of tuberculosis - with an increasing drug resistant TB epidemic –, and the highest recorded rate of rape. Migrants are at increased risk of violence and have limited access to health care.
MSF currently runs 4 projects in South Africa: 1. Piloting innovative models of care towards increased testing, linking, successfully treating (undetectable) and retaining people with HIV/TB, including DR-TB, in Khayelitsha; 2. Reducing HIV and TB incidence, morbidity and mortality via combination prevention in Eshowe & Mbongolwane; 3. Responding to Sexual & Gender Based Violence within a Large Migrant Population in Rustenburg; and 4. the Stop Stock Out Project monitoring stock outs of essential medicines in South Africa (as a member of a civil society consortium). In addition to medical service delivery, MSF conducts operational research, training and mentoring, and advocacy towards policy change in the areas of HIV, TB, sexual violence, vulnerable migrants, and patent law reform in South Africa.