- South Africa's antiretroviral (ARV) treatment program is the largest in the world, providing treatment to over 1 million people by 2010, though total need is estimated at 5.7 million. - The program faces challenges of expanding capacity to treat the additional 300,000 people in need each year given constraints of human resources, infrastructure, and drug supply. - Recent government efforts to address gaps include increasing the health budget, expanding treatment guidelines in line with WHO recommendations, implementing task shifting, and centralized drug purchasing to reduce costs.