The Queen Elizabeth Central Hospital in Blantyre, Malawi, is the largest hospital in Malawi. An ART Clinic providing free treatment was founded in 2004. The clinic is located in the centre of Blantyre and is affiliated with the Malawi-Liverpool Wellcome Trust Research Programme, and currently has 20 members of staff and volunteers. As of the 1st of April 2010, there were approximately 7500 HIV positive patients alive on treatment in this clinic, of whom approximately 6800 patients were on first-line treatment, and approximately 150 patients on second-line therapy. The site is experienced in clinical research including a nutritional supplementation clinical trial. The EARNEST site personnel are Dr. Joep van Oosterhout (PI), Dr. Jane Mallewa (Co-PI) and Chrissie Mtali (Trial manager) and these are ably supported by a comprehensive and enthusiastic team consisting of Mrs Rosemary Sikwese (Research Nurse), Grace Mwimaniwa (Research Nurse), and Symon Kaunda (Clinical Officer).