At the project’s inception, USAID/South Africa’s Health and HIV/AIDS Strategy was responding to the overwhelming challenges posed by the epidemic on individuals, families, communities and society in South Africa. There had been a dramatic rise in HIV infections during the previous decade threatening to undermine many of the advances made since efforts to transform the sector began in 1994. During the fifteen years prior to the project, HIV infection rates among pregnant women in antenatal clinics went from less than one percent (in 1990) to over 30 percent (in 2005).