Two weeks ago the health department put out a statement saying it ‘has officially taken over all the antiretroviral treatment (ART) projects initiated by Medicins Sans Frontieres (Doctors Without Borders) in South Africa since 1999.’ The two projects in question are the Lusikisiki programme in the Eastern Cape and Khayelitsha in Western Cape.
This comes after months of speculation that MSF is being pushed out.
Last Friday both the health department and MSF cleared up the confusion. ‘MSF is working as a partner in the Khayelitsha project but not leading it.’ said Dr David Kalombo, the accreditation official from the health department. ‘There is no confusion.’
MSF strongly reiterated their position in Khayelitsha saying they are have no plans to leave Khayelitsha but play a key supporting role with the provincial and city health departments. Marta Darder, spokesperson for MSF in Khayelisha said they do not pay for the AIDS drugs but their role is very on-hands and focussed on scaling up beyond the three clinics to meet the need. ‘MSF is contributing to TB and HIV integration process, monitoring and evaluating the ARV roll-out and looking at decentralisation of health services.’
Kalombo said MSF is no longer heading up the project but provides support. ‘I don’t know why everyone focuses on MSF. They are not leading the programme. We have many NGOs who are our partners like ARK, but it’s all government led programs.’
Doctors and activists say the statement undermines the role of MSF and creates the impression that MSF is no longer operating in either of the provinces.
Last month MSF handed over the Lusikisiki programme to the Eastern Cape health department. The programme was a partnership between the Nelson Mandela Foundation and the provincial health department. ‘One needs to understand that MSF started with a partnership in Khayelitsha in 1999 and Lusikisiki in 2003, within this understanding that we provided out of the box solutions,’ said.
Lusikisiki has been handed over to the Eastern Cape department with no MSF staff present. ‘We expect a level of panic in the initial handing over process but it is too early and incorrect to say the Lusikisiki programme is collapsing,’ said Darder. MSF will not be monitoring the ARV roll-out in the Eastern Cape. But Khayelitsha is a different story. ‘We have been in Khayelitsha longer than Lusikisiki but have 50 percent coverage of people who need ARV’s whereas when we left Lusikisiki we managed to get universal coverage,’ said Darder.
He said the statement is not misleading as both the programme. He also said the health department works in partnership with a number of NGOs and he does not see why MSF should be seen as exception.
Kolombo said the MSF pulled out of Lusikisiki because they ran out of funding and their partner, the Nelson Mandela Foundation ended funding. Darder vehemently disagreed: ‘We had funding from the Nelson Mandela Foundation that was planned for the two and a half year program. We certainly did not run out of funding. Lusikisiki was always going to be limited time period, whereas Khayelitsha has no time period.’