Over the last 10-15 years, poor African households have had to cope with the burden of increased levels of chronic illness such as HIV/AIDS. How do these households cope with the cost burdens of ill health and healthcare, and has this burden further impoverished them? What policy responses might better support these households? This is a report from the field of the South African Costs and Coping study (SACOCO) - a longitudinal investigation of household experiences in the Agincourt health and demographic surveillance site.