Bongi Sipamla works at St Luke’s Hospice, one of two care facilities supported by the Global Fund that serve the community of Khayelitsha, an impoverished township of almost half a million people just outside Cape Town. She cares for AIDS patients - many of whom arrive in a very poor state.

“Their living conditions are terrible.” she says, referring to the informal shack settlements which form large parts of the township. “People are too sick to access services offered by government. Women are bearing the burden of HIV, poverty is rife, and violence against women and sexual abuse are also very rife… But the situation is improving.” According to Bongi things are getting better due to the availability of drugs, beds in wards for those seriously ill with AIDS related infections, and professional care for patients in their own home.

In the late 90s, before effective HIV drugs became available, Bongi treated opportunistic infections associated with AIDS – mostly tuberculosis. She says she would see the same patients return again and again, each time in a worse state than before, until they died.

Now, with the availability of antiretroviral drugs (ARVs), financed in partnership by the provincial government, a Global Fund grant and PEPFAR, patients recover their health – and their way of life.

“Now when you come to the antiretroviral clinic there’s a different atmosphere. You see patients who are motivated to take their ARVs and you see them picking up weight and they’re blooming. And getting back to their jobs. Some even get better jobs as a matter of fact.” says Bongi.

The program fills a vital need in Khayelitsha where HIV prevalence is much higher than elsewhere in the country. It’s part of a nationwide program having a dramatic impact. There are around 460,000 people receiving antiretroviral treatment (ART) in South Africa. Not only does ART treatment help people recover their health, it also makes them less infectious. Another advantage is that if pregnant women receive ARVs in time it can help them give birth to children free of HIV as the transmission is dependent on the viral load of the mother.

However, Bongi regrets that people don’t come forward early enough – if they visit only at an advanced stage of illness there is a chance they will not make it, even with medical assistance.

South Africa has less than 1 percent of the worlds’ population, but in 2007 accounted for 17 percent of the planet’s HIV burden. About 5.7 million South Africans live with the virus – around one in eight people. There is more of a need for ARVs than is currently being met, with an estimated 1.7 million people requiring treatment.

Patients from St Luke’s Hospice are cared for in the community by health professionals linked to the facility. The carers are trained by Global Fund-supported programs and receive a small stipend for their services. They are the ‘backbone’ of the program, according to Bongi, “without the home based carers the programs would really collapse”. They are there to ensure that people living with AIDS get the care they need as they get back to living full lives.