Experience with establishing and expanding access to HIV care and treatment in Southern Sudan and Somalia shows that providing Antiretroviral treatment (ART) is possible even in very difficult situations. In Somalia, despite the prevailing security situation and a weak health system, there has been a steady increase in number of people living with HIV (PLWH) receiving ART over the past three years, while in Southern Sudan about 1000 patients have been taking ART in less than two years time.