 Task Shifting: In response to the severe shortage of health care workers in SSA, WHO and other organizations have advocated task shifting to lower cadre health care workers and lay individuals, including persons living with HIV PLWHIV, in order to maximize patients access to ART.36-39 Such strategies decrease physician resource requirements, allow for decentralized ART delivery, and improve patient retention.26,40-50 Médecins Sans Frontières MSF has developed a model of care which allows PLWHIV to become active participants in their own care and the care of other community members.49They successfully formed Community ART Groups CAGs to facilitate ART distribution, promote adherence, provide social support and monitor clinical status. During monthly group meetings a CAG member was chosen to represent each group at the clinic where each members status was discussed and the groups monthly ART supply was picked up. Retention was exceptionally high with 97.5 patients remaining in care for a median follow-up period of 12.9 months range 8.5-14 months. 