About one million people in need of anti-retroviral (ARV) treatment are yet to receive it in four southern African states, according to Medicins Sans Frontieres (MSF), a global nongovernmental organisation specialising in medical services. On the African continent, some 70 percent of people who need ARVs do not have access to the drugs.

Current assays which aim to distinguish between recent HIV infections and chronic ones, and therefore establish incidence (the annual rate of new infections), do not work in a west African context, a study from the Côte d’Ivoire finds. In nearly all scenarios, the researchers calculated, the tests would tend to grossly overestimate HIV incidence and underestimate declines in incidence.

A USAID study findings show that teachers are in need of teacher-centred programmes that provide education and services related to HIV prevention, care and support, and stigma reduction. As part of their Millennium Development Goals, the United Nations seeks to achieve “Education For All” by 2015. It is estimated that the number of teacher deaths in Kenya tripled between 1995 and 1999, with HIV and AIDS thought to be the largest contributor to teacher mortality (Kelly 2000).

The disintegration of the extended Swazi family, partly as a result of the HIV/AIDS epidemic, has created a new phenomenon of urban homelessness. A bitter early-winter cold front awakened Swazis this week to a problem nonexistent a decade ago: a seemingly permanent population of homeless people in urban centres.

The increased movement of people within Southern Sudan, including the return of hundreds of thousands of former refugees and internally displaced persons, could create a public health crisis across the impoverished region, a humanitarian official has warned.

More than a third of Swaziland's population is in need of food aid, after its worst ever harvest, said a UN food agencies' report.A prolonged dry spell has left around 400,000 vulnerable people in need of approximately 40,000 metric tonnes (mt) of food assistance until the next harvest in April 2008, according to a report by the United Nations' Food and Agriculture Organisation (FAO) and the World Food Programme (WFP), which was based on a joint assessment mission.

United Nations (UN) Secretary-General Ban Ki-moon’s appointment of activist Elizabeth Mataka as the HIV/AIDS Special Envoy for Africa is an important step for gender equality in Africa, and for addressing the impact of HIV/AIDS on women. On the same day, 21 May, the General Assembly reviewed progress towards universal access to HIV prevention, treatment, care and support, and discussed the impact of HIV/AIDS on women and girls.

Recent internal comments from the Global Fund to Fight AIDS, Tuberculosis and Malaria ("the Global Fund") suggest an intention to focus more on the three diseases, and to leave the strengthening of health systems and support for the health workforce to others. This could create a "Medicines without Doctors" situation in which the medicines to fight AIDS, tuberculosis, and malaria are available, but not the doctors or the nurses to prescribe those medicines adequately.

Malaria diagnostics are grossly underused and there is widespread over-treatment for malaria in patients with negative test results in Zambia, according to the findings of a cross-sectional survey published in the May 23-30th edition of the Journal of American Medical Association. The study calls for the provision of new tools to reduce the overuse of expensive antimalarial treatments and recommends a major change in the treatment of fever in patients without malaria.

Medecins Sans Frontieres’ (MSF) flagship antiretroviral programme in Khayelitsha is taking strain and has been forced to put patients on waiting lists as nurses and doctors struggle to cope with the growing demand. In a report titled “Help Wanted”, the humanitarian organization warns that efforts to further increase access to HIV treatment and maintain and improve quality of care are coming up against a wall due to the severe shortage of health workers.

Wasai J. Nanjakululu is a Kenyan based in Nairobi, working on HIV/Aids policy at the Agency for Cooperation in Research and Development (ACORD). In March, Saloman Kebede interviewed him on the forthcoming debate on continental government during the next African Union summit, June–July 2007.

This interview is one of several interviews with African citizens and CSO leaders on the AU proposal for continental government. Ivy Maina, consulting with the pan-Africa programme at Oxfam, edited the interview.

Saloman Kebede: What form of continental government does Africa need?

Wasai J. Nanjakululu: We recognise that we were given artificial states through colonialism. Breaking these states overnight is a daunting task. We should instead build these states to become federal states of Africa in order to end up with a federal government of Africa. This kind of government should then identify historical links that countries share and create regional states like the East African Federation. This may help in dealing with internal conflicts.

Saloman Kebede: Why is continental union important to African citizens, especially the poor and the marginalised?

Wasai J. Nanjakululu: If the continental union’s importance is based purely on political recognition, then what good shall come out of it? It must guarantee freedom of movement and free markets that work for Africa. This will also provide an enabling environment to mount a continent-wide HIV/Aids response. By making Africa one huge market we could jointly procure anti-retrovirals and establish pharmaceutical factories on the continent. This would ease the prices of these essential life saving drugs.

Saloman Kebede: What strategic areas of focus do you propose for the integration to be successful?

Wasai J. Nanjakululu: One, we need to break open state borders. Two, let the citizens be well informed and involved in policy making at country level, in order to allow people to engage democratically in governance, wealth creation and distribution. Then, when we propose the issue of African unity then the masses will not see the leaders as having hidden motives. Three, we have to come up with a good economic policy for African unity. Finally, let us be on the look-out for reactionary processes at country level and be prepared to deal with them.

Saloman Kebede: What obstacles must the AU overcome for the continental union to be successful?

Wasai J. Nanjakululu: I believe that you only see obstacles when you take your eyes off the goals. We also need to come to a place where we can allow others to lead but not allow the stronger countries to dictate to other states. The AU must embrace a culture of empowering its people and preserve the historical links that unite us.

Saloman Kebede: What one policy would your organisation propose to be adopted in continental integration?

Wasai J. Nanjakululu: All governments seem to recognise the role of the civil society in development. I would like all pan-African organisations to be registered within the AU and given a legal mandate to operate in all African countries. We need to avoid instances as those in Eritrea where ACORD was kicked out, or where some CSOs are being proscribed from Zimbabwe. Then we shall be able to engage across the continent and create overwhelming support and ownership for continental union government from the masses.

Saloman Kebede: What milestones would you like to see achieved within the first phase - the first two years?

Wasai J. Nanjakululu: I work with a pan-African organisation that works to build and strengthen African social movement. We are present in 18 countries in Africa. By opening up borders, we will cut costs on visa and interconnection of flights. Open the borders, let people, goods and services move. I am sure that can be done at a click of a finger from our heads of states.

Saloman Kebede: What meaningful decisions should the head of states make so that this process is people driven, rights based and publicly accountable to African citizens?

Wasai J. Nanjakululu: They should open up the debate in the media to popularise the proposal and involve the civil society and national parliaments.

The views expressed here are the perspectives of the interviewee. Jacob Wasai Nanjakululu can be reached at email: [email][email protected]

This World Health Organization page provides detailed information on country health profiles.

Like his neighbours in the southern Ethiopian district of Yirgacheffe, Birhanu Gizamu is a smallholder coffee farmer. Unlike the rest of the community, however, he has no hesitation in whipping out a crumpled blue card from the clinic which proclaims his HIV status. "I tested negative," the 42-year-old proudly noted, handing over the card for verification. "I went for [an HIV] test in 2005 after my wife pushed me, so we went together; I'd been in the military before becoming a coffee farmer, so I knew I was at risk."

The legalisation of same-sex marriages in South Africa in 2006 was expected to speed up the liberation of gays and lesbians in neighbouring countries like Zimbabwe and Namibia, where homosexuality is still illegal, but international and local experts believe the battle for recognition in Africa is far from over.

The indigenous forest people of central Africa have been largely isolated from the rest of the world, but as they become more integrated into mainstream society the risk of sexual exploitation and HIV/AIDS is a growing threat. Central Africa's pygmy populations, numbering a total of 300,000 to 500,000 people, have lived as hunter-gatherers in the forests of Burundi, Cameroon, the Democratic Republic of Congo (DRC), and the Republic of Congo (ROC) since time immemorial.

The Centre for Economic Governance and AIDS in Africa (CEGAA) and the International Budget Project (IBP), kindly sponsored by the FORD Foundation, are offering a two-week training to civil society organizations (NGOs)/ research agencies in: “Monitoring of budgets and tracking expenditure for health and HIV/AIDS” The training is to take place from the 18th to the 30th June 2007, venue still to be confirmed. For further information please contact: [email][email protected]

The white sandy beaches, inland salt formations and volcanic landscapes of Sal island, in the Cape Verde archipelago, off the coast of Senegal in West Africa, have been drawing in tourists from across the world, but experts warn that it has become vulnerable to the spread of HIV/AIDS.

The number of HIV-positive children accessing antiretroviral (ARV) treatment in Malawi is increasing, despite a scarcity of suitable paediatric formulas. An official in the health ministry, speaking under condition of anonymity, confirmed that adult tablets still had to be cut into smaller doses to treat children, but said this was a minor obstacle.

Rwanda's The Treatment and Research Aids Centre (TRAC) was this week internationally recognised for ensuring real time access of information on HIV/AIDS and Anti-Retroviral drugs (ARVs) nationwide through the use of Information and Communication Technologies (ICTs). Speaking to HANA, Dr. Anita Assimwe, the Managing Director of TRACnet said "the United Nations Economic Commission for Africa (UNECA) awarded TRACnet for its efforts in improving the health of Rwandans through the use of information technology."

At least 109 Tanzanians have become victims of the rift valley fever since the outbreak of the disease in January this year, the World Health Organisation (WHO) confirmed. The contagious viral disease is spread by the aedes mosquito. The mosquito infects animal blood and organs thus transmitting the virus to the milk.