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2015 MSF HIV/TB Clinical Guide.

Project Description

Welcome to the 8th edition of the MSF HIV/TB guide.  Free electronic copies (PDF versions) are available by clicking here for English and here for French.

The above image celebrates a bright day in December 2002, when Nelson Mandela came to visit our clinics in Khayelitsha. He came to offer political support, while we were confronted with strong HIV denialism from the National Government. He left people in no doubt regarding his personal convictions when, without hesitation, he swiftly put on the HIV positive T-shirt, an image which made world headlines.

By endorsing this T-shirt, he identified with the political struggle to gain access to ARVs. To have the world’s foremost statesman come to a destitute township like Khayelitsha, take off his shirt and don a strongly political T-shirt symbolised in one gesture what we had tried to do for a couple of years: make ARV treatment accessible to the poorest and most affected, as close as possible to where they live, in a country still completely divided along socio-economic lines.

This is what this clinical guide is about: it aims at motivating and equipping primary care health staff with necessary knowledge to treat HIV-related conditions and initiate adults, children, pregnant women on ARVs within their own clinic, even if they have no support available from a specialised health care centre. It aims to support HIV care at the grassroots level.

When we drafted the first edition of this guideline in 2000, we had no idea if we would succeed in such a tremendous challenge. This is the 8th edition and, in the meantime, major progress has been made in Khayelitsha: 28 000 on ART, including 3 500 children and a mother-to-child transmission rate reduced to 1.3%. Similar exponential coverage has taken place nationwide, despite a much later start.

This has had an immediate impact on reducing mortality by 27% in the last 5 years; increasing life expectancy in KwaZulu-Natal (KZN), a high HIV burden province, from 49.2 years in 2003 to 60.5 years in 2011. These figures are definitely impressive, but many challenges remain, mostly qualitative ones: we have to find innovative ways to keep initiated patients in long term care with undetectable HIV viral loads and, even more, we need to reduce new infections, particularly in young women, and eliminate vertical transmission; all of this in the absence of an effective vaccine, probably for the next decade.

This guideline is not close to becoming obsolete; despite impressive ART coverage, we still see ‘late presenters’ with advanced opportunistic infections coming to our clinics and hospitals. These patients often require high-level diagnostic and treatment procedures and, for this reason, a complement to this guide, aimed at addressing such complex cases referred for hospital care, will be soon released.

‘AIDS is a war against humanity’, said Nelson Mandela on that day in 2002. In making his symbolic gesture, he offered his own humanity to head the battle while giving many the courage to fight our worst enemies: stigmatisation and ignorance.

Let us together continue on this path, striving together to provide an increased quality of care to the people.

This guideline is dedicated to the memory of Madiba.

Eric Goemaere, February 2014


Screenshot 2015-07-04 18.10.28     Screenshot 2015-07-04 18.10.08

Project Details

  • Date June 30, 2015
  • Tags ARV, Diagnosis, Hepatitis, HIV, Monitoring, Opportunistic infection (OI), Patient education and counseling, PMTCT, TB

Responses (8)

  1. Mokhele M.A
    May 13, 2014 at 12:44 pm · Reply

    Requesting MSF Clinical Guide for HIV/AIDS and TB

  2. Gwen Samaai
    July 13, 2014 at 1:21 pm · Reply

    I have been working with patients with HIV for the passed 19 years now. It is so great to be afforded up to date information. I have also seen the drop in positive PCR s in the 6 week old as a result of ARV treatment made available to pregnant mums.

  3. Nozipho
    September 12, 2014 at 8:04 am · Reply

    Would you kindly do the trainings in Johannesburg.

  4. […] PMTCT and Paediatric HIV handbooks are available.  These two handbooks aim to complement the MSF HIV/TB Clinical Guide and are particularly useful for projects that focus on mother and child health (MCH) activities. […]

  5. Sarishna
    March 22, 2015 at 10:13 am · Reply

    Hi, how does one register to be notified if chapters in the book has been updated?

    • Peter
      March 30, 2015 at 12:34 pm · Reply

      Hi, Sarishna.
      Yes, the HIV/TB Clinical Guide is currently being updated to include the latest S.A. recommendations.
      Probably the quickest way to find out when the updated guide is ready is to register for the RSS feed (see icon in top right hand corner of website).
      We are aiming for the update to be ready sometime in April 2015…

  6. raza shah
    October 18, 2015 at 11:37 am · Reply

    i want to receive online training on malnutrition and medical side can anyone help me please

  7. Elisa
    December 11, 2015 at 4:22 pm · Reply

    Hi, i’m doing the HIV TB Online course and my next project in the next few week will be based on the PMTCT. How can i request an hard copy about the HIV TB Guideline and the PMTCT one?

    Thanks for the attention and for your work


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