An estimated 850,000 people are HIV-positive in Malawi - or 10% of the population (Source: UNAIDS 1999). Since the start of the epidemic, 390,000 children have lost their mother or both their parents - and there are 70,000 more orphans every year.

MSF works in the hospital in Chiradzulu in the south of the country, where it introduced ARVs in August 2001. Patients are included in the triple therapy programme when their CD4 count is below 200/mm3 (or stage 4 of the disease) or below 350/mm3 for pregnant women.

Patients must also live in the Chiradzulu district and be accompanied by a 'guardian' - someone from their family or village who can be there when they take their medicines and can accompany them on their weekly trips to the hospital for the first eight weeks of treatment.

There are 70 new patients included in the triple therapy programme every month. Of the 915 patients cared for in the MSF programme, 302 are now taking ARVs - including 170 women, 11 children and six pregnant women. 40 people have died, and two dropped out of the programme.

Two years ago, patients formed a "People Living With AIDS" (PWLA) group - they meet every month to talk about their lives and their disease, and also set up shows (theatre and songs) in local health centres for information and prevention. Some group members also distribute male and female condoms.