The Aids virus threatens to destabilise entire nations in Africa, an international conference on the disease was warned this week. Ministers from Botswana told the 14th International Aids Conference that their country was facing "extinction" because nearly 40 per cent of adults were infected. Their warnings came as activists marched on the conference in Barcelona to demand that two million infected people in the developing world were guaranteed access to anti-Aids drugs.

A two-week mass vaccination exercise against meningitis, which kills hundreds of people in West Africa each year, began on Monday in The Gambia.

The Burundi Office for the Coordination of Humanitarian Affairs (OCHA) presented on Monday a coordinated plan to counter the latest cholera outbreak, the UN agency reported. Two cholera-related deaths and 101 cases have been recorded since the outbreak began on 17 June in Bujumbura Mairie, the city centre.

Tanzania's new first line drug for treating malaria, Sulphadoxine Pyrimethamine (SP), has been embroiled in a high profile media scare over its potential side effects.

The G8 leaders allocated US$6 billion to Africa, not all of it new, and a paltry sum compared with the US$40-50 billion annually that the World Bank estimates is needed. Unfortunately Africa, and hence AIDS, seems to have dropped down the G8 leaders' list of priorities. The summit chairman, Jean Chrétien, put fighting terrorism first on his list of achievements of the summit. This reordering of priorities does not make sense. The scale of the HIV/AIDS pandemic, and its economic implications, are given in the UNAIDS document, Report on the global HIV/AIDS epidemic, prepared for the 2002 AIDS conference taking place in Barcelona, Spain.

Integrating dual-protection counseling and female condom provision into family planning services appears feasible, as is service providers' acceptance of dual-protection objectives. While providers and clients are key to transforming family planning to dual-protection services, the attitudes and behaviors of clients' male partners must be considered in gauging the success of the dual-protection intervention.

Activists in Kenya are seeking ways to reverse a new law which they say blocks the importation and local manufacture of much-needed cheaper, generic AIDS drugs.

Two pilot antiretroviral (ARV) programmes, underway in South Africa and Uganda, have demonstrated that AIDS treatment campaigns are possible in poor communities. What's missing to scale-up these initiatives into national programmes is funding, and the political will, healthcare workers say.

At the same time the Treatment Action Campaign (Tac) and Congress of South African Trade Unions (Cosatu) were holding a massive people's conference in Durban to fight HIV/Aids last week, Thabo Mbeki begged for increased commitments for Africa from G-8 leaders in Kananaskis, Canada.

Included amongst those commitments is the UN Global Fund, which according to Kofi Annan should logically reach $10 billion annually to meet Third World demands for inexpensive medicine, more health workers and improved facilities. But the Fund has received less than a tenth of that money, after George W. Bush denied a congressional allocation of $700 million in May.

Mbeki's search for aid, debt relief and investment resulted in "recycled peanuts," according to informed commentators. Mbeki and other African leaders were reduced to expressing "satisfaction" over their 90-minute appearance before Bush and his Northern cronies, which is a rhetorical measure of power imbalances and global inequity.

Mbeki's New Partnership for Africa's Development was bound to attract scepticism, particularly insofar as its corporate-friendly tone and content compels venal government elites across the continent to make themselves attractive for new investment.

Energised activists from the Tac/Cosatu conference will now have to raise the opposite question: how Africa-friendly are multinational corporations, particularly when so many African workers are HIV+, and when the leading corporations turn their back on anti-retroviral treatments?

Done properly, treatments would potentially transform the disease from inexorably fatal into a chronic illness such as diabetes, as has happened in much of the wealthier West.

But thanks to unemployment above 40%--if one counts those who have given up
trying to find a job under prevailing conditions-international and local firms are faced with a terrible option: replace sick workers with desperate, unemployed people instead of providing them treatment.

Perhaps the ethical challenge was expressed most eloquently by financier George Soros, who was asked about treating HIV+ South Africans by an SABC journalist in April. He answered, `I think to provide treatment to the bulk of the people is just not feasible. I think to provide treatment for instance to qualified workers actually saves money, actually saves money for companies.'

The interviewer responded, `Aren't you uncomfortable to talk in a way that is a kind of death sentence to those who we can't afford to treat?' Replied Soros, `I think the cost of providing actual treatment to everyone at the present... I don't think it's realistic. It's not achievable.'

In a more systematic way, the same conclusion was reached after a year of study at Africa's largest company, Anglo American Corporation. Anglo has 160,000 employees, of whom 21% are HIV+. After the pharmaceutical industry withdrew its lawsuit against Pretoria's potential use of imported generic drugs in April 2001, the company announced it would provide anti-retroviral medicines to its workforce, which meant literally tens of thousands of lives could be saved in the short term.

In June 2001, the Financial Times reported that`treatment of [Anglo's]employees with anti-retrovirals can be cheaper than the costs incurred by leaving them untreated.' In August, Anglo's vice president for medicine, Brian Brink, announced a strategy which 'involved offering wellness programmes, including access to anti-retroviral treatment.'

According to one press report, `The company believed that the cost of its programmes would eventually be outweighed by the benefits it received in gradual gains in productivity, [Brink] concluded. Although it was indeed a risky strategy, it was the only one Anglo could pursue in the face of such
human suffering.'

Then last October, Anglo simply retracted its promise, once cost-benefit analysis showed that 146,000 of those workers just weren't worth saving. According to the FT, Brink `said the company's 14,000 senior staff would receive anti-retroviral treatment as part of their medical insurance, but that the provision of drug treatment for lower income employees was too expensive.'

Brink explained the criteria for the fatal analysis: '[Anti-retrovirals]could save on absenteeism and improved productivity. The saving you achieve can be substantial, but we really don't know how it will stack up. We feel that the cost will be greater than the saving.'

His callous feeling became official policy a few months ago. As the Wall Street Journal recorded on April 16, `In a controversial move that could have wide ramifications for how companies in poor countries handle Aids, mining giant Anglo American PLC has put on hold a feasibility study to provide Aids drugs to its African work force, according to people familiar with the situation. When it disclosed its plans for the study a year ago, Anglo garnered wide praise because it was one of the first major corporations to reveal measures aimed at treating Aids cases among its rank-and-file African employees.'

A month later, South Africa's most eloquent pro-corporate commentator, Ken Owen, defended the merits of Anglo's policy in a Business Day column: `I am sceptical about most doomsday economic scenarios generated by the Aids epidemic... For the rest of this decade, at least, the lost workers will be quite readily replaceable from the millions of unemployed, and society will adjust in a myriad of ways to labour shortages. For example, a million domestic workers constitute a reserve pool of labour that can be drawn into
industry.'

Where does this display of corporate arrogance-bordering on culpable homicide--leave the treatment-activist movement? Will the April 2001 victory over Big Pharma and the expected Constitutional Court ruling against Mbeki on access to drugs for pregnant HIV-positive women allow HIV/Aids activists to turn, with their labour and other international solidarity allies, against capital?

The answer may lie in changing the terms of costs and benefits, by making firms socially liable-even if merely through old-fashioned protest--for killing their workers through malign medical-insurance neglect. With Anglo attempting to shine at the World Summit on Sustainable Development in August, opportunities abound for global humiliation of the genocidal tendencies at these mega-wealthy multinational corporations.

(Wits University political economy professor Patrick Bond is editor of 'Fanon's Warning', a new book critical of Nepad, published by Africa World Press and the Alternative Information and Development Centre.)

Only 30,000 people out of almost 30 million now living with the death sentence of HIV/Aids in sub-Saharan Africa are being given the drugs that keep infected men and women alive, well and working in Britain, in spite of the promises of help from rich nations over the past two years. As a devastating report from UNaids on the scale of the epidemic and its human and economic cost was published this week, it became clear that a vast gulf still exists between those who will die in the absence of treatment and those whose lives can be indefinitely prolonged by modern medicine.

Orphans at the Juvenile Remand Home savour a rare meal. An UNAids report says 15 per cent of Kenya's adult population (about 2.5 million) are living with Aids. Only South Africa and Nigeria have more infected people. Kenya has the third highest number of Aids orphans in the world, estimated at 890,000, a shocking new report by the United Nations says. Only Nigeria with a million orphans and Ethiopia with 990,000 have more.

Zambia has joined Zimbabwe in expressing concern over accepting genetically modified (GM) food aid, while the country struggles to overcome food shortages threatening over two million people.

Zambia may become the second African country - after Uganda - to reverse a widespread HIV/AIDS epidemic, a new UNAIDS report said on Tuesday.

A country's policy on healthcare financing can help or hinder access to services by poor people. How can different approaches to resource allocation enable poor people to access essential health services? A report from the UK Department for International Development's Health Systems Resource Centre presents lessons from Cambodia, South Africa and Uganda.

Insecticide-treated bednets (ITNs) are widely promoted as a malaria prevention tool. The role and cost-effectiveness of indoor residual house spraying (IRS) for malaria control have received less attention. Research by the Kenya Medical Research Institute and other institutions found that IRS might be more effective and cheaper than ITNs in communities prone to epidemics of infection.

Trachoma is an infectious eye disease that can cause blindness. It effects an estimated 150 million people worldwide, mostly in poor rural areas of Africa and Asia. Existing treatments, including tetracycline eye ointment, are unsatisfactory. So how can the World Health Organisation achieve its goal of a trachoma-free world by 2020?

Previous international AIDS gatherings have tended to be "scientific showcases", but community-based organisations and children's NGOs are hoping for a higher profile at the 14th International Conference on AIDS to be held in Barcelona, Spain next week. "In the past, we felt that the community arm of the programme in international conferences had been tacked on as an afterthought, but this year looks to be different," Debbie Matthews, programme manager for the AIDS Foundation of South Africa, told PlusNews on Monday.

The high prevalence of sexually transmitted infections (STIs) and their role in HIV transmission have made integrating STI prevention and management into existing family planning and antenatal care programs a goal in most resource-poor countries, especially in Sub-Saharan Africa. However, little is known about how integrated services can best be configured, and what impact they have on prevention of infection and unwanted pregnancy.

There is a pressing need to understand better how to ensure the translation into policy and practice of important research findings in HIV/AIDS prevention and care in countries threatened by fast spreading HIV epidemics. This paper reviews the findings and implications of a policy analysis case study of an HIV/AIDS clinical trial that has been successful in influencing HIV prevention policy relevant to low-income countries in order to identify illustrative lessons for HIV/AIDS researchers in the future.

As this nation of 10 million people faces its most serious food crisis in recent memory, government officials are encouraging farmers to plant trees as part of a long-term effort to improve soil fertility and increase food supplies.