The challenge of HIV/AIDS in Sub-Saharan Africa

At the end of 1998, an estimated 67% of people living with HIV/AIDS in the world were in Sub-Saharan Africa some 22.5 million people(1). The challenges posed by the HIV/AIDS epidemic in this resource-poor region are enormous. The most important is to reduce the number of new infections: simple interventions such as barrier methods of contraception and better treatment of sexually transmitted diseases must be implemented now whilst waiting for an effective vaccine. There is also a need to understand more comprehensively the clinical spectrum and natural history of the disease in the region. However, with an ever-growing demand for care caused by HIV/AIDS, probably the most compelling yet insoluble challenge is how to provide wider access to very costly specialist services, including antiretroviral therapy.