Malawi is making great strides in overcoming decades of underdevelopment and the growing impact of HIV/AIDS.

MSF in Malawi 2014

43,300 patients on first line antiretroviral treatment
400 patients under treatment for tuberculosis
£5m expenditure
586 MSF staff

Since 2007 the landlocked southeast African country made real progress in achieving economic growth as part of programmes instituted by the government of President Bingu wa Mutharika in 2005.

But, a major limitation to healthcare provision is the shortage of skilled healthcare workers – the vacancy rate for clinical staff is around 60 percent in a country of nearly 18 million people.

Médecins Sans Frontières/Doctors Without Borders (MSF) has worked in the country since 1986 and provides a wide range of medical care, from HIV and tuberculosis (TB) treatment to maternal health and natural disaster response.

Patient story

Abebe Aleme, 41. He left Ethiopia for South Africa to look for a job but he was arrested and detained in Malawi.

"We go to South Africa because in our country we don’t have enough to live. In South Africa if I go I work for two years, I can have something to buy a house.

"In Ethiopia, if you work even 20 years you buy nothing. This is why we leave our country.

"In prison, here, we are not human. We lost everything. The shoes I have were given to me by a friend. We sleep on cement. We have pain in the morning.

"And what they give us as food is bad, too bad. There is no soap. We pray to God every day to be free soon."

Staff story

Umberto Pallecchio, MSF anthropologist working in Maula prison

"The worst is at night. The heat emanating from dozens upon dozens of bodies is so stifling it’s palpable.

“The men are squeezed together on the cement floor, with a space of less than half a square metre per person on average.

“Packed tightly like battery hens for 15 hours a day, the inmates sit up in rows, their heads lolling on their knees, occasionally rolling onto a neighbour’s shoulder.

“Prisoners in Maula get food only once a day. They usually eat a plate of nsima – ground maize that fills the stomach but doesn’t give many nutrients. Beans are an occasional treat. Nutrition is so poor that last month MSF had to treat 18 inmates for moderate-to-severe malnutrition.”

MSF’s work in Malawi: 2014           

For many years MSF has been supporting the national health system to strengthen its HIV response through staff training and technical support. 

We are always testing innovative treatment models to reach more people with the virus.


In August, MSF began a four-year handover process with local health authorities and continues to simplify HIV treatment.


We are working to prevent mother to child transmission of HIV by putting all HIV-positive pregnant and breastfeeding women on antiretroviral treatment.

The team is also developing a programme to treat tuberculosis in 14 health centres.

Also, we are working to improve counselling, testing and treatment services for sex workers, couples in which only one person has HIV, adolescents and people with advanced HIV.


Our handover of first-line HIV treatment to the Ministry of Health was completed in December 2013, but MSF teams continue to mentor local staff who provide second-line treatments and viral load testing to patients.

Prison project

We started a new project in two prisons: Maula in Lilongwe and Chichiri in Blantrye. Some 4,400 inmates and staff were screened for HIV, TB, hepatitis B and sexually transmitted infections (STIs).

Mozambique border

In 2014, a project offering testing for HIV and STIs to truck drivers and commercial sex workers began in Mwanza and Zalewa, near the border with Mozambique, More than 300 sex workers and 50 truck drivers were tested.

A map of MSF's activities in Malawi, 2014.

Find out more in our 2014 International Activity Report.

At the end of 2014, MSF had 586 staff working in Malawi. MSF first began working in the country in 1986.


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