Médecins Sans Frontières has been running HIV/AIDS treatment programmes since 2001. As national systems scaled up capacity, MSF began to hand over HIV projects in 2005. Variable experience with handover and internal debates about MSF responsibility to patients led OCG to propose an evaluation of the handover process, to learn from experience and inform policy and practice. A qualitative review was carried out through interviews, case studies in Cameroon and Laos, and review of other vertical and integrated HIV projects.