Heroes in the North West Province

How communities are keeping children safe from HIV’s deadliest stage

For many families in the North West, HIV is not just a statistic — it is a daily fight for survival. Without treatment, the virus weakens the body’s defences, opening the door to life-threatening infections such as TB, meningitis, and pneumonia. This advanced stage, known as Advanced HIV Disease (AHD), remains one of the greatest dangers for children and adults living with HIV.

But AHD is not a death sentence. With the right care, daily medication, and the support of caregivers, families, and communities, it can be prevented, managed, and even reversed.

What is AHD?

AHD occurs when the immune system is severely weakened — either because the body has too few CD4 cells (the “soldiers” of immunity) or because other illnesses have taken hold. Antiretroviral Therapy (ART) is the key: it keeps the virus under control and helps the immune system recover.

Stopping treatment allows the virus to multiply quickly, leaving a person vulnerable. The World Health Organization (WHO) recommends restarting ART without delay, screening and treating common infections, providing preventive medicines, and offering strong caregiver support. With early action, even children diagnosed with AHD can recover and thrive.

The everyday struggles behind treatment

Taking medication daily may sound straightforward, but for many families living in poverty, the barriers are steep. HIV medicine often needs to be taken with food — a challenge when there isn’t enough to eat. Costs linked to transport and clinic visits create additional pressure. Recognising and addressing these realities is essential if children are to stay on treatment.

Yet, communities across the North West embody the spirit of ubuntu. Families and neighbours continue to come together, ensuring children are cared for and given a chance to live beyond their diagnosis.

Heroes on the ground

In the North West, Civil Society Organisations (CSOs) are stepping in to make this possible. Through the IMPAACT4HIV partnership, groups such as Lefika La Ka, Boithuto Lesedi Project, Lifeline Rustenburg, and the Dr Nthuseni Murudi Foundation are rewriting the future for children and adolescents living with HIV.

Working closely with the Bafokeng Community Health Centre, these organisations:

• trace children who miss clinic appointments,
• provide transport and counselling for caregivers,
• support schools so learners can continue their education while staying in care, and
• link households to health and social services.

By offering both emotional and practical support, these local heroes make it far more likely that children will remain in school, take their medicine consistently, and have food and stability at home.

Why it matters

The North West Province carries one of the heaviest HIV burdens in South Africa:

• 22.7% of adults (15–49) are living with HIV.
• Only 57% of children under 15 with HIV are on treatment.
• Of those, just 75% have their virus under control.
• Among adolescents (12–19 years), prevalence has risen from 3.2% in 2012 to 4.1% in 2017 — with teenage girls most at risk.

Without intervention, many of these children risk progressing to AHD. But with consistent care and community support, HIV can be controlled, AHD prevented, and lives rebuilt.

A future beyond the diagnosis

The good news is that AHD can be treated. With timely ART, good food, rest, and community support, recovery is possible. Each child who stays in school, each parent who receives counselling, and each neighbour who lends a hand represents another step forward.

In the North West, the fight against HIV is being won not only in hospitals and clinics, but in homes, schools, and villages. It is being carried by everyday heroes — caregivers, teachers, health workers, and community organisations who refuse to let children be left behind.     

Sources: UNAIDS 2022; WHO 2021; Spotlight NSP 2025; National Adolescent HIV Study 2021