Report: Lay Health Workers for an HIV Free Generation

In April 2011 MSF started an HIV/TB project called ‘Bending the Curves’ in King Cetshwayo District in KwaZulu-Natal, South Africa, with the aim of reducing HIV & TB incidence, mortality and morbidity in a high prevalence area. Working in partnership with the KwaZulu-Natal Department of Health, MSF has introduced community and facility-based activates dedicated to increasing the update of HIV/TB testing, counselling and enhancing access to treatment.

Several of these initiatives are run by lay health workers – health workers who are trained to carry out some health care services, but who are not medical professionals. Between 2012 and 2019, the majority of all HIV testing and counselling in MSF’s catchment area was performed by lay health workers which contributed greatly to the area’s achievement of the UNAIDS 90-90-90 targets. Once initiated on ART, patients are provided with counselling conducted by lay counsellors.

It is in large part thanks to the works of lay counsellors and other lay health workers that the ‘Bending the Curves’ project achieved the UNAIDS targets of 90-90-90 in 2019, one year ahead of the 2020 goal, with results of 90-94-95: 90% of people living with HIV know their status, 94% of those were on antiretroviral treatment and 95% of those had a suppressed viral load.