1. Until a cure and a vaccine is found, prevention and control will depend largely on social and administrative measures. Effective detection and education are pre-requisites to prevention. Surveillance, detection, education, prevention and control require an environment that is not hostile to people asking questions, seeking advice and help and discussing openly. Severe stigmatisation, possible self incrimination under the law or a general attitude that HIV/AIDS should be kept hidden are not conducive to disclosure and open discussion. Prevention and protection come together (Helene Gayle). Without respect for human rights for those affected, detection will be hampered.

2. When I was in S. Africa last year for the AIDS Conference, I read, "Young, Talented and Dead" in a newspaper headline in bold and big type. This is what happens when an epidemic becomes out of control. It causes loss of, not just lives, but of generations of people and it wrecks economies. The scale of human devastation is beyond belief. This is why every window of opportunity must be seized to prevent its spread. This requires concerted societal effort and government leadership.

3. Prevention requires a clear framework – administrative directives, policies, methodologies or law, as long as they are binding. It is too big an issue to allow each community to only undertake those actions which are convenient to them. The framework should cover:

• policy binding upon each level of government
• blood screening/drug abuse
• harm reduction measures – needle exchange programme, usage of condoms
• corresponding decriminalization of offences
• privacy
• anti-discrimination
• education/protection of health workers
• community participation methodologies which must be widely participatory and must enable people take ownership of the issue.
• corporate voluntarism
• sex education
• testing

4. One factor that I feel must be borne in mind is the added danger where economic and political interests merge and come under the same source of control. If government authorities prefer to hide the occurrence of HIV/AIDS because it fears a reduction in investment interest, this will drive HIV/AIDS underground and cause severe deprivation of the economic, social and cultural rights of those with HIV/AIDS. It will shut them out.

5. An HIV/AIDS national strategy needs to be sensitive and realistic in the context of the resources and social-economic conditions of a country.

6. It is most impressive that the railway network is being used as a distribution system for educational materials. It is the backbone to the country's transport system and it unifies the country. It is a very effective communication system. It would be nice to have video centers in stations too.

7. Other networks can also be considered of course. These include tagging educational messages onto products that are being distributed widely. One can consider household goods and personal hygiene products. Basic knowledge on breast cancer was, for instance, tagged onto personal hygiene products.

8. Women in the family need to be targeted. Education can help them to protect themselves and prevent transmission through pregnancy. Their caring role in the family also means that they normally teach the young and can transmit information.

9. Public Security Offices can also be used for dissemination of information and to provide assistance. The issue here, however, is whether the ordinary public comfortably sees the Public Security Office as offering a service and not as a law enforcer. The same applies to the police here and elsewhere. The people see them more as officers holding clubs rather than as servants of the people.

10. The NGO's play a very important role in meeting service gaps. They are flexible, do not suffer from bureaucratic constraints and are not feared by others. It is also far easier for NGO's to be linked up with networks outside the country for experiences to be shared and common problems discussed.

11. Lastly, there needs to be International co-operation. HIV/AIDS knows of no geo-socio-economic boundaries. Sharing expertise and experience will make us a better and healthier people.

End