South Africa’s health care system continues to struggle with its response to the devastation of HIV, while at the same time respecting its mandate to provide equitable health services to all. The adult HIV prevalence for 2009 was estimated at 10.6% in the general population, while prevalence among pregnant women attending antenatal clinics (ANC) for 2008 was about 29.1%. The health care system, already markedly under-resourced, has been severely stressed by critical shortages of nurses, as increasing numbers of people require care and treatment for HIV. As the heartbeat of the system, nursing and midwifery is the universal access point for care by most people in African countries (up to 90% of patients are seen by nurses only), and nurses and midwives now have expanded roles to meet the urgent healthcare needs of the HIV sector.