MSF closed all operations in Lusikisiki at the end of October 2006. That date marked the end of four years of operations setting up a model of comprehensive and decentralized HIV care in one of the poorest and most underserved rural areas in South Africa with a high prevalence of infection. The model implemented has been widely used in South Africa to influence relevant policies. This report looks at the chain of events following the handover and changes in the model of care.