In his recent state of the Union address, the President of the United States, George W. Bush, announced a 15-billion dollar five-year commitment to address HIV/AIDS in Africa and the Caribbean. This large, but still insufficient amount of funds is aimed at preventing seven million new infections of HIV in both targeted regions. However, the question is who, and what, projects will benefit from the promised US funds? As Khopotso Bodibe reports, delegates at the African Women'€™s Sexual and Reproductive Health Rights (AMANITARE) Conference, held in Johannesburg recently, grappled with this question.

In an attempt to understand the nature and spread of HIV, experts have shifted attention from classical epidemiology to a socio-political analysis. In contrast with the developed world, the number of women with new infections in Africa are increasing, exceeding that of men by around two million. There is enough anecdotal evidence that factors linked to under-development such as gender inequity and that are characteristic of the developing world are intricately linked with increased vulnerability to HIV/AIDS. An analysis of the spread of HIV/AIDS in Africa shows that its heightened prevalence amongst women can be traced to patriarchal ideology so prevalent in parts of Africa. Khopotso Bodibe of Health-e News Service, explores this system and its grave consequences.

In November, mining company Anglo-Gold reached a critical milestone in its fight against AIDS in the work place with the first administration of anti-retroviral therapy to employees who qualify for treatment and are willing to participate in the pilot project. The plan will be implemented in phases and is expected to be complete by April 2003, thereby reaching about 200 of the company'€™s HIV positive employees in less than a year of existence. Khopotso Bodibe reports.

As 2002 dragged on, debate around the HIV/AIDS crisis in South Africa centred largely around the provision of anti-retroviral drugs in the public sector. As the year drew to a close there were a few positive indications that there might be some genuine movement on the issue. Khopotso Bodibe reports.

Gauteng province has been hailed as the most proactive in its drive to implement PEP services to prevent HIV infection in survivors of rape and sexual abuse. In the following report by Khopotso Bodibe, we hear about the province'€™s progress in the roll-out of this potentially life-saving programme.

We continue to explore PEP services for rape survivors in our Living with AIDS slot. Without this service the South African public health system would be failing our children, many of whom also experience the sexual abuse and rape that continues to plague our communities. Khopotso Bodibe looks at the services available for these most vulnerable members of society.

Since national protocols for the implementation of PEP programmes for rape survivors in the public health sector were laid out in May, the Gauteng government has moved with congratulatory speed and commitment. On the 31st of June, the provincial Department of Health launched its first phase of implementation of the programme. To date, 26 have been established centres across the province '€“ both in urban as well as less-developed areas '€“ to offer free post-exposure prophylaxis for the care and treatment of survivors of rape. But, as Khopotso Bodibe reports, the success of the programme so far, cannot be measured convincingly as most clients fail to follow through on the treatment after their initial visits.

In this report, Khopotso Bodibe attempts to explain what post-exposure prophylaxis - anti-retroviral drugs now freely afforded to survivors of rape in public health facilities are '€“ and how they work.

'€œTen-year-old boy arrested after rape of five-month old baby'€, read one newspaper headline over the New Year. '€œPolice arrest four men out of six in the act of gang-raping at gun-point'€, read another. Two of countless examples of horrific crimes against children and women that seem to have become part of daily life in South Africa. In the face of HIV/AIDS, these reports confirm the assertion that it is the behaviour of South African men that fuels the epidemic. Unless men are challenged or change their attitudes we might just lose the battle against HIV and AIDS. Khopotso Bodibe of Health-e News Service, reports.

Parallel to the review programme on nevirapine currently taking place in Uganda under the guidance of the United States'€™ National Institutes of Health, the MCC in South Africa is conducting its own investigations locally at sites where nevirapine is being used for PMTCT. In our second and last instalment on the review effort, Khopotso Bodibe, explores the local segment of the investigation.

The Medicines Control Council held an urgent council meeting on the 5th of November, following its receipt in October of an interim report from America'€™s National Institutes of Health (NIH) on the on-going review programme of nevirapine. The report, received more than a month later than expected, provides details of Phase One of the two-stage investigation. In the following report by Khopotso Bodibe, the Registrar of Medicines Precious Matsoso, couldn'€™t reveal details of the council meeting, nor the contents of the preliminary report from the NIH, citing a secrecy agreement.

The question that AIDS activists have been asking is: Are the vaccines that will be tested in South Africa specific to sub-type C, the virus that is predominantly circulating in the country and the southern African sub-region? Khopotso Bodibe put that question to Dr Eftyhia Vardas, Director of the HIV/AIDS Vaccine Division at the Peri-natal HIV Reseacrh Unit at Chris Hani Baragwanath Hospital, in Soweto.

Three years after the establishment of Nkosi'€™s Haven in Berea, Johannesburg, and one year after the death of the celebrated young AIDS activist Nkosi Johnson, a new home for HIV positive mothers and their children has been opened in Berea, in honour of the late Nkosi.

Despite delays caused by protocol, preparations for the AIDS vaccine trials in South Africa are still underway and clinical researchers and scientists are hopeful that the Phase One tests will start early next year. This sense of optimism follows months of discussion and debate amongst the Medicines Control Council, the government as well as the vaccines'€™ developers. It is hoped that the extensive consultations will help accelerate the onset of the vaccines trials '€“ the search for the ultimate hope in HIV prevention. Khopotso Bodibe went out to seek clarity on the outstanding issues.