The first free AIDS drugs clinic in S.Africa celebrates 10 years of lifesaving success, but also warns of the new challenges facing in the treatment programme.
The trailblazing project in shack-filled Khayelitsha in Cape Town began at a time when South Africa's government questioned the causes of AIDS and a health minister dubbed "Dr Beetroot" advocated vegetables over proven measures.
The courts later forced the government to offer medication, and South Africa now has the world's largest treatment programme.
The benefits of treatment were touted in the results from the first free clinic, where mother to child transmission has dropped to 2.5 percent, lowered death rates, and boosted testing from 450 to 55,000 per year.
"Khayelitsha is showing that it is possible to eradicate the transmission of mother to child," said Eric Goemaere, medical advisor for Doctors Without Borders, which started the clinic in 2001.
"We don't speak about a research setting or about the sophisticated hospitals in the United States. We speak about Khayelitsha: 2.5 percent, it's absolutely amazing."
But making sure that people kept taking the drugs was a challenge with only 65 percent of patients after five years still following their treatment which risks the need for expensive new medicines.
After five years of medical care, about 12 pecent of patients need second-line treatments when an initial cheaper cocktail of drugs had failed, a report on the project said.
That number is expected to rise. One in 10 patients who failed second line treatment already need to switch to a next round of drugs not available at state hospitals. That medication costs up to 15 times as much as the first cocktail.
Now one million people receive anti-AIDS drugs in South Africa, which has the world's most HIV infections, affecting 5.6 million of the 50-million population, according to UN estimates.