Unlike the previous conference in 2005, when organisers were unsure even a day before the conference opened whether government officials would take part, Deputy President Phumzile Mlambo-Ngcuka will open the conference this evening.

Health minister Dr Manto Tshabalala-Msimang, returning to office after months of sick leave, is due to address the conference tomorrow (Wednesday 6 June) and much is riding on the tone she chooses to adopt.

In Tshabalala-Msimang’€™s absence, a new spirit of cooperation has developed between the health department and HIV/AIDS organisations who have hammered out the country’€™s National Strategic Plan on HIV/AIDS to guide the country until 2011.

However, AIDS activists report that a number of health officials have started to pull back from them in the past few weeks on hearing that Tshabalala-Msimang intended to return to office.

It is unclear whether the minister will be willing and able to adapt to the new modus operandi which is based on negotiation rather than decree.

Conference convenor Dr Olive Shisana has organised two pre-conference meetings of key stakeholders aimed at achieving consensus on some of the current AIDS hot potatoes. A draft declaration on areas of agreement will be presented to conference delegates for adoption, and is expected to provide practical steps on how the National Strategic Plan can be implemented.

‘€œTop local and international scientists participated in drafting the national strategic plan,’€ said Shisana. ‘€œMany of them will be among the 4 000 delegates attending the conference because they are committed to working together to implement this plan.’€

Preventing HIV infection is a major focus of the conference, unlike in the past when the focus was on antiretroviral treatment.

Male circumcision is one of the hot topics, following recent studies that have shown circumcised men have a significantly reduced risk of becoming infected with HIV than uncircumcised men.

The conference is expected to recommend that medical circumcision is made available to all South African boys and men. However, much debate is expected on how male circumcision can be introduced, given that it is part of important coming-of-age cultural rituals.

One of the barriers to effective prevention is that less than a quarter of people with HIV are aware that they have the virus and are thus unknowingly infecting others.

The conference is likely to agree on the need for expanded HIV testing facilities, especially ones aimed at men and young people. In addition, it is likely to call for HIV counsellors to be empowered to perform HIV tests instead of nurses being required to do so by law.

Other impediments to HIV prevention, including the high rate of rape and the widespread practice of people having a number of concurrent partners, are also likely to be addressed.

Scientists are likely to push for greater government, private sector and donor support for the development of microbicides (vaginal gels to prevent HIV infection) and a vaccine.

At present, a number of microbicide and vaccine trials are underway in the country. But should these trials be successful, the country has little capacity to manufacture vaccines particularly on a large scale.

The role of traditional medicine and nutrition ‘€“ long controversial in this country ‘€“   will also get a look-in at a special session to be addressed by the World Health Organisation’€™s Randa Saadeh and the University of KwaZulu-Natal’€™s Professor Nceba Gqaleni.