A recent edition of the Africa Focus Bulletin examines the problem of health resources for Africa. Despite their commitment early this month to write off debts to multilateral institutions by 18 developing countries (see http://www.africafocus.org/docs05/debt0506.php), says the Bulletin, rich countries have barely made a start in meeting the demands to address Africa's needs. "While debate tends to focus under the standard themes of debt, aid, and trade, activists in the health field are taking the lead to stress that the framework needs to be changed to a common obligation to invest in universal rights rather than a narrow conception of charitable "aid" from donors to recipients."

A cholera epidemic that broke out in the capital Bissau last month is spreading into the interior of the country, with more than 400 new cases reported nationwide over the past week, health officials said Friday. Since the beginning of the epidemic on 11 June, a total 1,027 cases have been registered, including 12 deaths, said Simao Mendes, director of Bissau’s General Hospital.

Doctors at two of Zimbabwe's largest referral hospitals have embarked on an indefinite strike, demanding a pay rise of more than 100 percent and a special allocation to cover escalating fuel costs caused by the ongoing petrol shortage. Junior and mid-level doctors at Harare's Parirenyatwa and Central hospitals vowed on Wednesday not to resume work until the government had met their demands.

Services at Tanzania's largest medical facility, the Muhimbili National Hospital, have deteriorated further after the government failed to resolve a dispute with medical interns who have been on strike for more than a week, demanding increased allowances. "We tried our best to convince the interns to go back to work, but it appears some of them were not ready to call off the strike," Hussein Mwinyi, the deputy minister for health, told a news conference on Tuesday when he announced the government's termination of the services of the striking interns.

At least 100,000 people living with HIV/AIDS in Tanzania will receive anti-retroviral drugs (ARVs) free of charge by the end of 2006, Prime Minister Frederick Sumaye announced last Thursday. "The target is to ensure at least 400,000 people are on free ARV treatment within the next five years," he said in a speech before parliament in Tanzania's administrative capital, Dodoma.

Nurses' and doctors' leaders have called on the UK Government to tackle the "poaching" of overseas healthcare workers, at next month's G8 summit. They say staff migration from developing nations is killing millions and compounding poverty. The British Medical Association and the Royal College of Nursing have written to Tony Blair demanding urgent action.

The belief that lack of "good governance" might be the main hindrance to economic growth in Africa was firmly set in the minds of the international community following a World Bank report in 1989. Rarely recognised is that the inspiration came from African scholars and that the current use of the concept diverges significantly from their own original understanding, writes Thandika Mkandawire. Director of UNRISD. "For the African contributors, good governance related to the larger issues of state-society relations and not just to the technocratic transparency-accountability mode it eventually assumed in the international financial institutions."

Plans to purchase a US $545,000 limousine for President Bingu wa Mutharika have sparked heated debate in Malawi, which faces yet another year of acute food shortages. Finance Minister Goodall Gondwe told parliament on Wednesday that the Maybach 62, made by Mercedes-Benz, was necessary, as the president was without an official vehicle. The car used by former president Bakili Muluzi was involved in an accident last year, and the government intended to pay for the new vehicle in instalments.

Cholera outbreaks in Uganda have killed at least 10 people, while hundreds of others have been treated for the disease, health officials said last Thursday. The outbreaks were recorded in a congested Kampala slum; in Jonam County in Nebbi District, 300 km northwest of the city; and in a camp for internally displaced people in Gulu District, 380 km north of Kampala. In the slum, north of the city centre, four deaths and four cases of infections have been recorded. The slum is home to an estimated 30,000 people.

Non-governmental Organisations (NGOs) in the country have been urged to sit back and reflect on themselves as civil society activists. In a key-note address to a Gender Festival in Dar es Salaam, Issa Shivji, Professor of Law, University of Dar es Salaam, said reflecting on who we are, what are we doing and where we are going does not require any justification. In other words, he queried, are we contributing to the great cause of humanity, the cause of emancipation from oppression, exploitation and deprivation, or are we engaged, consciously or unconsciously, in playing to the tune set by others?

African nations are refusing to accept US Food and Drug Administration approval of generic AIDS drugs, delaying the delivery of the less costly medicine to patients, according to US, UN, African, and drug company officials, The Boston Globe reports. Four countries - Nigeria, Uganda, Ethiopia, and Tanzania - have told South African generic drug maker Aspen Pharmacare that its FDA approval for antiretroviral drugs had no standing in their regulatory reviews of medicine, and that they have long required a study of the drug's safety and quality from the World Health Organization, officials confirmed in interviews last week.

Angola still has one of the highest rates of child mortality in the world, says UN Children's Fund (UNICEF) Country Representative, Mario Ferrari, and challenges relating to children remain huge. Three years after the end of the country's 27-year long civil war, "the situation is that the long period of war had the effect of dismantling the social services, weakening social services in a radical way in the country. The effect is that ... this country has a child mortality rate of 250 per 1,000 - one of the highest in the world," Ferrari told IRIN.

Patient fees are deterring poverty-stricken Nigerians from participating in a government-subsidised scheme to provide HIV/AIDS medication, according to a coalition campaigning for free access to the life prolonging drugs. According to the coalition, which includes French NGO Médecins Sans Frontières (MSF) and representatives of people living with HIV/AIDS, the monthly charge of 1,000 Naira (US $7.50) for the antiretroviral (ARV) medication is more than many Nigerians can afford.

Early HIV testing is an important factor for the successful implementation of HIV/AIDS treatment programs in African countries, Ernest Darkoh, former operations manager of Botswana's public antiretroviral drug program, said last Tuesday at the 2nd South African AIDS Conference in Durban, South Africa, Reuters AlertNet reports. About 1,000 AIDS advocates and health professionals were expected to attend the three-day conference.

Despite good outcomes in many treatment centers, the message from reports and demonstrators at the Second South African AIDS Conference in Durban last week was that the government's 18-month- old plan for AIDS treatment in the public sector is still falling far short, reports the latest edition of the Africa Focus Bulletin. Results are very uneven among provinces, few children are receiving treatment, nutrition programs as well as antiretroviral (ARV) drugs are failing to reach the majority of those needing treatment, and there is still no plan to address the critical shortage of medical personnel.

A company involved in the production of artemisinine, an anti-malaria drug, is due to set up extraction plants in Kenya and Tanzania to make the drug easily and cheaply available to patients, an official for the company said on Wednesday. The factories would be established in East Africa because of the potential in the region for cultivating artemisia-annua, the plant from which the anti-malaria drug is extracted, the managing director of African Artemisia Limited, Geoff Burrell, said at a conference convened by the UN World Health Organization (WHO) in the northern Tanzanian town of Arusha.

Angola has made "limited progress" in improving the country's health network since the devastating 27-year civil war ended three years ago, according to a new report by the UK Department for International Development (DFID). Progress in implementing new health sector projects funded by UN agencies and other donors has been affected by poor capacity, noted the report on a case study by researcher Suzanne Fustukian of DFID's Health Systems Resource Centre.

A critical shortage of medical staff in Zambia is compromising the quality of public healthcare as doctors and nurses continue to leave the country in search of more lucrative employment. Zambia has about 10,000 registered nurses for a population of around 10 million, according to statistics released by the health ministry in 2004.

The World Health Organization in December 2004 urged all member countries to consider mechanisms for pooling financing for healthcare, including Social Health Insurance, in order to achieve universal coverage. The Health Economics Unit at the University of Cape Town offers a 5-day short course addressing the changing role of health insurance in low- and middle-income countries. The course focuses on the financial management of risk pools in diverse settings covering a broad spectrum of insurance arrangements including community-based health insurance, private voluntary insurance for the formal sector and social or national health insurance.

The Tanzanian government last Thursday said it will increase spending by 24.7% in the upcoming fiscal year to allow it to distribute antiretroviral drugs to HIV-positive people at no cost, implement poverty-reduction programs and pay for an election, Reuters reports. The Tanzanian government earlier this year announced that it plans to increase the number of HIV-positive people receiving antiretroviral drugs at no cost from about 4,000 to 44,000.