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The main focus of MSF's activities in Malawi continues to be improving care for HIV patients, particularly adolescents and other vulnerable groups. A lot of improvement has been made but HIV remains the leading cause of death among adults.

In Malawi, where nearly 1 million people are living with HIV, MSF runs projects to support efforts to combat the virus. The country’s ambitious HIV program has already achieved significant success.

Médecins Sans Frontières has worked in the country since 1986, supporting the national health system to strengthen its HIV response through staff training and technical support and trying out innovative treatment models to reach more people with the virus.

MSF teams provide a wide range of medical care, including tuberculosis (TB) treatment, maternal healthcare, and natural disaster response.
 

11 year old Gloria stands outside her family house while an MSF doctor checks her X-Ray. © Sola / MSF

HIV Care

MSF is developing specific activities aimed at improving management of vulnerable patient groups and their adherence to treatment. MSF initiatives include setting up comprehensive, multidisciplinary services for adolescents, patients facing difficulties in staying on treatment, and those not responding to treatment. Sex workers and men who have sex with men have both a higher risk of contracting HIV and a lower access to antiretroviral care due to stigma and discrimination as well as, in many instances, their illegal status and high mobility.

Our dream is to find a way to ensure continuity of care for these vulnerable and highly mobile groups.

Marc Biot
Médecins Sans Frontières’ coordinator of operations for Southern Africa.

Comprehensive care for sex workers

The transnational “Corridor” project was launched in January 2014, in order to find innovative ways of increasing access to life-saving antiretrovirals (ARVs) and encouraging adherence to care. As part of the project along transport routes between Malawi and Mozambique, MSF provides comprehensive HIV, TB and sexual and reproductive health services, for truck drivers, sex workers, and men who have sex with men in one-stop clinics in Mwanza, Zalewa, Dedza and Nsanje.

In Nsanje, MSF is supervising the implementation of a policy to put all HIV-positive pregnant and breastfeeding women on ARVs, regardless of their clinical status, to prevent transmission of the virus to their babies. We also support the severely underfunded district management team in running a fully decentralised HIV and tuberculosis (TB) program that includes infants newly diagnosed with HIV.

Anna Laison, 16 years old, from Ntipasonje Village is an MSF patient (HIV and TBC positive).

 

How do you feel living with HIV?
At first, it was difficult to accept that I have HIV. So I was living with stress and sometime I was mad with my mother, and sometime people could mock me saying am a patient. But now I accepted my status and I don’t complain.

Do you think peoples face changed when they look at you?
Yes some people look changed when they look at me.

What is the main constraint for someone living with HIV?
The only constraint I face on day to day life is discrimination. People sometimes discriminate you because you have HIV. They will not let you participate some activities and this has been happening to me.

Is there anything you don’t do because you have HIV?
YES, during the wedding ceremonies the organisers do not put me in bridal party just because am HIV. Sometimes it is hard to play with friends they discriminate me.

What changed in your life since you know you have HIV?
Nothing has changed.

Greatest regret – I don’t have any regret
Greatest hope – I will finish my school and get a job.

Prison project

In Chichiri and Maula prisons, MSF is providing a package of screening and primary healthcare for HIV and TB, as well as improving water and sanitation services for inmates. MSF is calling for it to be implemented nationwide, and for the extreme overcrowding and malnutrition in prisons to be addressed.

Prevention and early treatment of cervical cancer

Malawi has the highest rate of cervical cancer in the world. Only 10%-20% of women in the country receive early screenings and preventive vaccination is not implemented. MSF is developing a comprehensive project in Blantyre city and Chiradzulu district, including screening and treatment for pre-cancerous lesions, vaccination against human papillomavirus, treatment for cervical cancer and palliative care.

All progress made in Malawi relies heavily on international funding, and there is a critical lack of qualified healthcare staff. Malawi’s massive budget deficit has hit the health system hard. In addition, international donors have withheld budget support since 2014 due to corruption scandals.

Find out more about Malawi

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