After 12 years of operations, we closed our HIV/TB project in Eshowe, KwaZulu-Natal province. The project’s community-oriented approach helped to increase the integrated management of HIV, TB, diabetes and hypertension through nine community-based ‘Luyanda’ sites, which were successfully handed over to the DoH. Many achievements were made in the task-shifting of TB health promotion activities to teachers in schools, and we shared valuable feedback with the DoH on the decentralisation of Drug-Resistant Tuberculosis (DRTB) services to the primary healthcare level.

Flash flooding in parts of KwaZulu-Natal province in April 2021 caused hundreds of deaths, displaced over 40,000 people and severely damaged infrastructure, including water and sanitation services. MSF launched a substantial emergency response comprising medical teams and water, sanitation and hygiene experts. We supported mobile clinics in affected communities with medical staff and provided water storage and sanitation in shelters for displaced people. In addition, our geohydrologists implemented innovative techniques for improving water yield and quality from strategically drilled boreholes.

In September 2022, after 22 years, our teams working on HIV/AIDS and drug-resistant TB (DR-TB) in Khayelitsha handed all remaining activities over to authorities. We launched the project in the context of HIV/AIDS denialism at the highest levels of government, starting by working to improve methods to prevent mother-to-child transmission of the disease, and were soon allowed to expand our involvement to HIV treatment for people of all ages, as well as operational research. One of the project’s standout achievements was the integration of HIV and TB services in clinics. It also contributed to the improvement of DR-TB treatment and care by demonstrating that it is possible to substitute toxic injectable antibiotics with newer and more effective oral drugs.

At the end of 2023, we handed over our Tshwane Migrant Project to authorities and a local Community-Based Organisation after building the capacity to work with undocumented populations. The project provided access to medical care for undocumented people and migrants and actively advocated for continued access.