The formation of HAACO was initiated by Medecins Sans Frontieres (MSF) who had been operating a HIV/AIDS project since 1999 in Khayalitsha in the Western Cape and since 2003 in rural Lusikisiki in the Eastern Cape province. Most of the services provided by the MSF project were handed over to the DoH. However the adherence element was not. The DoH had neither the financial nor the structural capacity to take on the Adherence programme. Hence the formation of HAACO. This process was intended to review the strategic options for the future of HAACO. This Review aims to provide an overview of what we see, in the present functioning of HAACO, as well as some ideas and guidance for the ongoing and future development of HAACO and its work. The specific objectives were to establish whether HAACO interventions are working or not, and at what cost, to consider ways in which HAACO can be strengthened, and to propose some considerations for the future strategic direction of HAACO. The Review was conducted by two practitioners from footsteps, a not-for-profit association of Organisation Development (OD) and development practitioners working with Civil Society Organisations (CSOs) in Africa.