Twenty years ago, treatment for HIV was a rare luxury in South Africa. Exorbitant costs and President Thabo Mbeki’s government’s fierce opposition to providing antiretroviral treatment (ART) kept it out of the public sector.
The environment has changed remarkably since then. The turning point came in 2004 when, after four years of struggle, led by the Treatment Action Campaign, the government begrudgingly agreed to start providing ART.
Antiretroviral coverage of people with HIV in South Africa has increased from 0% in 2000 to 71% in 2019. The South African antiretroviral program is now the largest in the world, with more than five million people on treatment, and increasing. HIV-linked deaths decreased from 150,000 in 2000 – peaking at around 300,000 in 2006—to 72,000 in 2019.
But deaths have not decreased as much as was hoped. HIV remains a leading cause of death in South Africa. Many people still present to
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