For more than 20 years, MSF's Khayelitsha project in South Africa’s Western Cape province has been an incubator of innovative responses to HIV and drug-resistant TB, always putting the needs of patients at the heart of what they do.

The project opened the first antiretroviral therapy programme in South Africa, pioneered integrated management of HIV and TB, developed the world’s first HIV treatment adherence clubs, and has been at the forefront of efforts to guide the decentralisation of drug-resistant TB treatment and care.

In 2018, the project started a post-exposure program for children and adolescents who have been exposed to DR-TB within their households. From 2020, with COVID-19 keeping people indoors this included the offer of preventive therapy to all high-risk household contacts who were exposed to DR-TB in the home.

We were able to enrol more than 120 household contacts in just over 12 months, and learned many important lessons that are today influencing global policy on TB prevention.