Last week, regulars at the HIV treatment clinic at Pelonomi hospital, in Bloemfontein, capital of South Africa's Free State Province, would have told you that the clinic has never been this quiet. Ever since the provincial government stopped initiating new patients on antiretroviral (ARV) drugs, the buzzing treatment literacy classes for people about to start taking ARVs had shrunk in size, while some existing patients stopped coming to check whether their drugs were in stock.

Pamela (not her real name), a resident of Kenya's largest slum, Kibera, continues to experience pain and discomfort one year after she was gang-raped when election-related violence erupted in the country. "The saddest part of the experience is that I don't know the rapists so I can't even say I am waiting for justice; they pushed my head under the bed and so many of them raped me until I fainted; when I came to, they had fled," Pamela said.

With increasing demand for resources to tackle the global HIV/AIDS epidemic, questions arise as to where such resources are to be found and whether they can be fully absorbed and spent. One major source of financing for HIV and AIDS control is external aid. The debate continues as to whether increased external assistance causes macroeconomic instability.

States emerging from protracted crises struggle to provide basic services. This is no more crucial than in the health sector where vulnerable ‘post-conflict’ populations are frequently in dire need of care. However, development actors are frequently faced with difficult choices – particularly how much emphasis to place on ‘humanitarian’ emergency health relief in the face of a need for health systems building. Yet is it possible to simultaneously provide basic health services whilst also developing local health provision?

Botswana's government has warned that it may have to cut or completely withdraw its HIV/AIDS funding, despite the rising number of people needing treatment, as the global economic crisis takes a toll on the vitally important diamond-mining sector. The government is the main financier of the national HIV/AIDS response, contributing up to 80 percent of the budget, with donors making up the remainder. But the global economic slump has led to significant declines in the sale of diamonds, Botswana's most important revenue source.

Some 53 million West African children will be vaccinated against polio in schools, health clinics and their homes over the next month to tackle risks from the paralysing virus in Nigeria. The $67 million campaign, spanning eight countries, aims to increase immunity levels in one of the last strongholds of the disease that the World Health Organisation (WHO) and UNICEF have spent more than 20 years and $6 billion trying to eradicate.

King Mswati III, has expressed concern over the standard services in the health sector of the country. He said the situation is unfortunate because the south African country has several health professionals working abroad. The Prime Minister of Swaziland has disclosed that the King has charged his officials to engage all working professionals outside the country to find the cause of leaving their home soil.

Although cholera fatality rates and new cases are on the decline, the epidemic is still not under control. As of 26 February, 84,027 suspected cases, including 3,894 deaths had been reported by the Ministry of Health and Child Welfare, with a slight drop in the fatality rates to 4.6%.

cc With doubts lingering over its ultimate productivity, Lim Li Ching seeks to dispel fears around ecological agriculture’s low yields and demonstrate its capacity to be more than simply an idealistic socio-environmental approach. Drawing upon evidence from Ethiopia’s Tigray Project and data accrued from a variety of environments around the world, Lim Li discusses the benefits of using compost in place of chemical fertilisers and scope for ecological agriculture’s greater use in enabling countries, regions, and individual families to achieve improved crop yields and more sustainable food sources.

The recent two-percent drop in HIV prevalence in Zambia may not be a true reflection of the state of the pandemic in the country, health officials have warned. UNAIDS Monitoring and Evaluation Advisor Dr Michael Gboun told IRIN/PlusNews that while there has been a marked decline of HIV in the general population, some geographical areas and groups were showing an alarming increase.

Starting antiretroviral therapy earlier, before the development of symptoms, is the most likely way to reduce the high death rates after treatment initiation seen in people with HIV in resource-limited settings, two large cohort analyses show. The studies also show that the major disadvantage of starting treatment late - an increased risk of death - may persist for some years, burdening already overstretched health systems with illness that could be avoided by earlier treatment.

HIV prevalence in Kenyan adults has remained relatively steady since 2003, at around 7%, according to a major national study presented to the Sixteenth Conference on Retroviruses and Opportunistic Infections (CROI) on Wednesday. However, less than one in five HIV-positive adults were aware of their HIV status, and over half had never been tested for HIV at all.

Pia Engebrigtsen worked for 2 months as a nurse in Zimbabwe's Masvingo province during the country's cholera outbreak, in which MSF has so far treated more than 45,000 people. Here she shares her story of death, heartbreak, survival and saving lives against all odds.

Negotiations are underway on the services agreements towards concluding a full and comprehensive Economic Partnership Agreement (EPA) between East and Southern African countries (ESA) and the European Union (EU). The services negotiations will impact on health services and access to health care. The brief outlines the issues affecting health services, and presents options for ESA negotiators to ensure that the negotiations meet international and African health and human rights commitments, use available trade flexibilities, promote public health and ensure adequate assessment and information to support the negotiations.

IPHU and PHM UK are pleased to announced 'People, politics and Global Health; Actions to change the approach', a six day short course for health activists, scheduled for London, 30th March to 4th April, 2009. IPHU aims to contribute to achieving Health For All by strengthening the people's health movement by providing learning opportunities which are well targeted and address priority learning needs and which are well designed and presented.

Stepping Stones, a 50 hour programme, aims to improve sexual health by using participatory learning approaches to build knowledge, risk awareness, and communication skills and to stimulate critical reflection. This article in the British Medical Journal details the results of a randomized trial to measure the impact of the Stepping Stones programme on HIV and herpes simplex type 2 (HSV2) rates in rural South Africa. The trial also measured unwanted pregnancy, reported sexual practices, depression, and substance misuse.

Findings from two Ugandan studies suggest that home-based HIV counselling and testing may augment traditional HIV counselling and testing services in important ways in some settings, both by increasing acceptance and uptake of HIV testing, but also by impacting attitudes toward HIV at a population level. The results of both studies were presented to the Sixteenth Conference on Retroviruses and Opportunistic Infections (CROI) on Wednesday by Sundeep Gupta of the Centres for Disease Control, Uganda, on behalf of the investigating teams.

Rwanda is in the process of adopting male circumcision as a part of its national HIV prevention strategy, but experts worry that a spike in requests before a planned public awareness campaign has been launched could have negative implications. Alphonse Ndakengerwa, a surgeon at King Faisal Hospital in the capital, Kigali, said clinics in the city had recently been overwhelmed by requests for the procedure, largely as a result of media reports on research indicating a lower risk of HIV infection in circumcised men.

The High Level Conference on Food Security in Madrid on the 26th and 27th of January excludes the main stakeholders in the debate on the food crisis from meaningful participation. It is a forum dominated by the World Bank, IMF and WTO, as well as transnational companies such as Monsanto, and it is an outrage that they are given space on the panels of discussion while representatives of small farmers - who produce 80% of the world's food – are left only a few minutes on the floor to give their position.

After years of delays, HIV/AIDS funding in the Central African Republic is finally making its way to thousands of HIV-positive people in desperate need of care and treatment. Hope and excitement were in the air in 2003, and again in 2004, when the Global Fund to Fight AIDS, Tuberculosis and Malaria allocated two grants, totalling US$40 million over five years, to combat HIV/AIDS in the Central African Republic (CAR), where an estimated prevalence of 6.3 percent makes it the hardest hit country in central Africa.