Sassou Mjibola Deputy Director, African Regional Office  World Health Organization

 Two AIDS vaccines are being tested in Africa now.   We might consider a "holding action" until vaccines are available.  

What is essential is that we have inexpensive test kits.  We should insist that test kits from India be imported into Africa, not Western kits.  The  Western kits test for HIV-1b, not for the multiple other strains we have in Africa.  Indian kits are cheaper too.    Dr. Pradeep Seth and Dr. Mohammed Najeet Siddiqi from the All India Institute of Medical Sciences developed an AIDS test kit;  it targets all the strains in India.  Maybe some World Bank funds ought to go to these researchers to see if they can develop a test that targets  other African strains.  

Let's not use the Haitian standard.  We should  not give to the worst off,  but to the ailing but still functioning.    We can arrange for the targeted patients  to come to a specific place each morning and give 100 the medications at one time.  Ten locations in a city would mean 1000 would be  treated.  The same process can be scheduled for early evening.  It can't be that difficult for a few people--not doctors or nurses-- to check off the names of those on a list--and watch them take the pills.    In a few days, the "watchers" would recognize the people     I'll wager that 10,000 or 20,000  could be treated in any African country, daily.  Those who check off the names can star  those who seem to be in decline and insist they go in for more testing.  

We can  start a treatment program in big cities, then expand to smaller towns, and finally to villages.  From 10,000 to 100,000 in a year--if we have the drugs.  Who should we give the meds to?  How about 20% to top political-economic elites, 20% to mid-elites, 20% to mothers with kids, 20% to security forces, and 20% to workers --including sex workers.  We can be very quiet about the latter, and emphasize that we are treating "innocents" who became infected.  They'll take the meds--it's a matter of life and death.  

Let's not rely on  pharmaceuticals, NGOs, missionaries, hospitals, Western-sponsored-clinics for treatment.    They have their needs; we have ours.   We know who must be saved.