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Washington, D.C., Center for Global Development, 2015. 68 p.Founded in 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) is one of the world’s largest multilateral health funders, disbursing $3-$4 billion a year across 100-plus countries. Many of these countries rely on Global Fund monies to finance their respective disease responses -- and for their citizens, the efficient and effective use of Global Fund monies can be the difference between life and death. Many researchers and policymakers have hypothesized that models tying grant payments to achieved and verified results -- referred to in this report as next generation financing models -- offer an opportunity for the Global Fund to push forward its strategic interests and accelerate the impact of its investments. Free from year-to-year disbursement pressure (like government agencies) and rigid allocation policies (like the World Bank’s International Development Association), the Global Fund is also uniquely equipped to push forward innovative financing models. But despite interest, the how of new grant designs remains a challenge. Realizing their potential requires technical know-how and careful, strategic decisionmaking that responds to specific country and epidemiological contexts -- all with little evidence or experience to guide the way. This report thus addresses the how of next generation financing models -- that is, the concrete steps needed to change the basis of payment from expenses to something else: outputs, outcomes, or impact. (Excerpts)
Washington, D.C., Center for Global Development, 2016 Feb. 38 p. (Center for Global Development Working Paper 425)This paper uses contract theory to suggest simple contract designs that could be used by the Global Fund. Using a basic model of procurement, we lay out five alternative options and consider when each is likely to be most appropriate. The rest of the paper then discusses how one can build a real-world contract from these theoretical foundations, and how these contracts should be adapted to different contexts when the basic assumptions do not hold. Finally, we provide a synthesis of these various results with the aim of guiding policy makers as to when and how ‘results-based’ incentive contracts can be used in practice.
[International financial cooperation in the fight against AIDS in Latin America and the Caribbean] La cooperacion financiera internacional para la lucha contra el SIDA en America Latina y el Caribe.
Cadernos De Saude Publica. 2014 Jul; 30(7):1571-6.This study analyzed the financial contribution by the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria and its relationship to eligibility criteria for funding in Latin America and the Caribbean in 2002-2010. Descriptive analysis (linear regression) was conducted for the Global Fund financial contributions according to eligibility criteria (income level, burden of disease, governmental co-investment). Financial contributions totaled US$ 705 million. Lower-income countries received higher shares; there was no relationship between Global Fund contributions and burden of disease. The Global Fund's international financing complements governmental expenditure, with equity policies for financial allocation.
Tropical Medicine and International Health. 2008 Sep; 13(9):1188-95.The Debt2Health Conversion Scheme of the Global Fund to Fight AIDS, Tuberculosis and Malaria is used to reassess a range of recent initiatives that propose debt relief in exchange for spending in the health sector. The experience with debt swaps in the mid 1990s was far from positive, and recent improved insight in the economics of debt relief suggests extreme caution. We argue that the recent spade of debt swap proposals, even if targeting countries and debt titles that fall outside current major international debt relief mechanisms, share most of the design faults of previous initiatives. Proposals such as Debt2Health do not constitute efficient vehicles to increase net transfers to poor countries, to reduce the economic disadvantages of indebtedness, or to strengthen public health systems of partner countries. For debt relief to constitute a valuable mechanism to provide aid, it should be designed as a large-scale and comprehensive operation, with spending earmarked to broad country-established priorities, and reinforce rather than undermine national implementation systems.
Bethesda, Maryland, Abt Associates, Partners for Health Reform Plus, .  p. (USAID Contract No. HRN-C-00-00-00019-00)The Global Fund to Fight AIDS, TB and Malaria aims to attract, manage, and disburse resources that will make a significant and sustainable impact on the three focal diseases. The Global Fund has also stated its commitment to support programs that address the three diseases "in ways that contribute to the strengthening of health systems." The Global Fund is likely to have a variety of direct and indirect effects upon health care systems that could be positive or negative in nature. To be effective and sustainable in the long run, interventions will depend upon well-functioning health systems. This is true not only for the Global Fund, but also for other initiatives, such as the World Bank Multisectoral AIDS Program (MAP), the President's Emergency Plan for AIDS Relief, and others that aim to substantially increase the scale of response to specific diseases, particularly HIV/ AIDS. (excerpt)
Bulletin of the World Health Organization. 2007 Aug; 85(8):586-592.WHO's new Global Plan to Stop TB 2006-2015 advises countries with a high burden of tuberculosis (TB) to expand case-finding in the private sector as well as services for patients with HIV and multidrug-resistant TB (MDR-TB). The objective of this study was to evaluate these strategies in Thailand using data from the Thailand TB Active Surveillance Network, a demonstration project begun in 2004. In October 2004, we began contacting public and private health-care facilities monthly to record data about people diagnosed with TB, assist with patient care, provide HIV counselling and testing, and obtain sputum samples for culture and susceptibility testing. The catchment area included 3.6 million people in four provinces. We compared results from October 2004-September 2005 (referred to as 2005) to baseline data from October 2002-September 2003 (referred to as 2003). In 2005, we ascertained 5841 TB cases (164/100 000), including 2320 new smear-positive cases (65/100 000). Compared with routine passive surveillance in 2003, active surveillance increased reporting of all TB cases by 19% and of new smear-positive cases by 13%. Private facilities diagnosed 634 (11%) of all TB cases. In 2005, 1392 (24%) cases were known to be HIV positive. The proportion of cases with an unknown HIV status decreased from 66% (3226/4904) in 2003 to 23% (1329/5841) in 2005 (P< 0.01). Of 4656 pulmonary cases, mycobacterial culture was performed in 3024 (65%) and MDR-TB diagnosed in 60 (1%). In Thailand, piloting the new WHO strategy increased case-finding and collaboration with the private sector, and improved HIV services for TB patients and the diagnosis of MDR-TB. Further analysis of treatment outcomes and costs is needed to assess this programme's impact and cost effectiveness. (author's)
Lancet. 2007 Jul 28; 370(9584):311.In 1983, Michel Kazatchkine was a clinical immunologist at the Hôpital Broussais in Paris, France, when he was called to see a French couple with unexplained fever and severe immune deficiency who had been airlifted home from Africa. This man and woman were the first of many AIDS patients that Kazatchkine would take care of in the coming decades. There were no effective antiretroviral treatments available, and the couple lived only a few months on the ward before dying. "Those were difficult years with patients dying every day on the wards", Kazatchkine recalls. Much of his time, he says, was spent providing end-of-life care, consoling patients, "and holding their hands when they were dying". This year, after more than two decades of working in AIDS clinical care, research, and international programmes, Kazatchkine takes over the helm of the second largest funder of AIDS care: the Global Fund to Fight AIDS, Tuberculosis & Malaria. Anthony Fauci, Director of the US National Institute of Allergy andInfectious Disease, who says he has worked "up close and personal" with Kazatchkine since the early days of the epidemic, calls him "the perfect kind of person for the position". He's a scientist who understands the science; a clinician who understands clinical care; and an expert in AIDS who understands the epidemic, Fauci says. "He's also a fine 'people person': the kind of person who can build consensus, but also the kind of person who can take the lead." (excerpt)
Lancet. 2007 Jul 28; 370(9584):307-308.This spring the Global Fund to Fight AIDS, Tuberculosis and Malaria announced that its programmes had treated nearly 3 million tuberculosis patients, distributed more than 30 million insecticide-treated bednets, and were providing antiretroviral drugs to more than 1 million people infected with HIV. After nearly 5 years of operation "Global Fund programmes are saving 3000 lives a day", says the Fund's new executive director Michel Kazatchkine. The Fund was launched in 2002 to raise, manage, and disburse funds to fight three leading killers of people in poor countries: HIV/AIDS, tuberculosis, and malaria. At the time, efforts to combat those diseases were fragmented and woefully underfunded. The Fund's narrow focus has won it the approval of foreign-aid sceptics such as William Easterly, professor of economics at New York University in New York City and author of the book White Man's Burden, which critiques many current development programmes. "One of the curses of foreign aid is that each agency tries to do everything; and when you try to do everything, you tend to do a mediocre or bad job", Easterly says. (excerpt)
Integration between sexual and reproductive health and HIV and AIDS and malaria: opportunities and strategic options for the Global Fund to Fight AIDS, Tuberculosis and Malaria. Discussion piece.
[London, England], HLSP, 2006 Nov.  p.There is a growing body of knowledge which emphasises integration of sexual and reproductive health (SRH) as critical to the effectiveness of responses to HIV and AIDS, and the success of HIV and AIDS programmes. Further, accelerated headway in malaria prevention and/or treatment can be achieved through integration with SRH efforts. This paper briefly explores the evidence base for integration, identifies the enabling environment at global and national levels and discusses the opportunities and challenges for supporting integration by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund). The paper concludes with strategic options for the Global Fund. (excerpt)
Washington, D.C., United States Department of State, Office of the United States Global AIDS Coordinator, 2005 Jun. 184 p. (USAID Development Experience Clearinghouse DocID / Order No. PC-AAB-508)This June FY 2005 Operational Plan serves as an update of the February 2005 Operational Plan. The FY 2005 Operational Plan follows "The President's Emergency Plan for AIDS Relief -- U.S. Five-Year Global HIV/AIDS Strategy" and sets out a course to have an immediate impact on people and strengthen the capacity of governments and NGOs to expand programs quickly over the next several years. By the end of FY 2005 the Emergency Plan will provide direct and indirect care and support for approximately 3,500,000 individuals, and will facilitate access to antiretroviral therapy for at least 550,000 individuals. Section III of this document provides information on each country's contribution to the total number of individuals to be receiving care and support and antiretroviral therapy by the end of FY 2005. The country-specific target tables also provide the FY 2008 care and treatment targets for each country. The FY 2008 targets were set at the beginning of the Emergency Plan. The sum of all countries' FY 2008 care/support targets equals the Emergency Plan's goal of ten million individuals receiving care and support by the end of year five. The sum of all countries' FY 2008 treatment targets equals the Emergency Plan's goal of two million people on treatment at the end of year five. (excerpt)
Bulletin of the World Health Organization. 2007 Mar; 85(3):200-206.International interest in the relationship between globalization and health is growing, and this relationship is increasingly figuring in foreign policy discussions. Although many globalizing processes are known to affect health, migration stands out as an integral part of globalization, and links between migration and health are well documented. Numerous historical interconnections exist between population mobility and global public health, but since the 1990s new attention to emerging and re-emerging infectious diseases has promoted discussion of this topic. The containment of global disease threats is a major concern, and significant international efforts have received funding to fight infectious diseases such as malaria, tuberculosis and HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome). Migration and population mobility play a role in each of these public health challenges. The growing interest in population mobility's health-related influences is giving rise to new foreign policy initiatives to address the international determinants of health within the context of migration. As a result, meeting health challenges through international cooperation and collaboration has now become an important foreign policy component in many countries. However, although some national and regional projects address health and migration, an integrated and globally focused approach is lacking. As migration and population mobility are increasingly important determinants of health, these issues will require greater policy attention at the multilateral level. (author's)
Incorporating a rapid-impact package for neglected tropical diseases with programs for HIV / AIDS, tuberculosis, and malaria: A comprehensive pro-poor health policy and strategy for the developing world.
PLoS Medicine. 2006 May; 3(5):e102.The last five years have witnessed increased efforts by G8 nations and United Nations agencies to improve the health of the world's 3 billion people living on less than US$2 a day. Most of this attention has focused on efforts to intensify resources for fighting the three most devastating diseases: HIV/AIDS, tuberculosis, and malaria. Together, these "big three" account for a staggering 5.6 million deaths and the loss of 166 million disability-adjusted life years (DALYs) annually (see annex tables 2 and 3 in). Prominent partnerships and initiatives are now devoted to the big three, and increased global attention to these diseases (and to the risks posed by avian influenza and other emerging viral infections) culminated in the November 2005 TIME Global Health Summit, branded by Bono as the "Woodstock of Global Health". These new initiatives and "Woodstock" Global Health have done much to raise funds and elevate public awareness in order to launch a serious war on the big three. Conspicuously absent from these activities, however, has been commensurate advocacy for a group of diseases that exclusively affect the poor and the powerless in rural and impoverished urban areas of developing countries. An increasing body of evidence indicates that this group of "neglected tropical diseases" may not only threaten the health of the poor as much as HIV/ AIDS, tuberculosis, or malaria, but even more importantly, may have effective treatment and prevention strategies that can be delivered for less than US$1 per capita per year. Furthermore, new evidence points to substantial geographic overlap between the neglected tropical diseases and the big three, with emerging data suggesting that control of the neglected tropical diseases could actually become a powerful tool for combating HIV/AIDS, tuberculosis, and malaria. (excerpt)
Challenging, changing, and mobilizing: a guide to PLHIV involvement in country coordinating mechanisms.
Washington, D.C., Futures Group, POLICY Project, 2004 Dec. 99 p.The aim of the handbook is to increase and improve the meaningful participation of PLHIV on CCMs across the world. This development will undoubtedly enhance the ability of the Global Fund to be an effective force in serving the communities most in need and will also contribute to facilitating PLHIV access to Global Fund resources. There are already many useful resources available nationally (though not in every country) and internationally to assist PLHIV in developing various types of skills and knowledge; however, none is specific to PLHIV who are involved in Global Fund CCM processes. We realized during the consultations that we could fill hundreds of pages with useful and relevant information, so instead of duplicating material that already exists, we will refer to it where appropriate. To the greatest extent possible these resources have been included on the CD that accompanies this handbook. (excerpt)
Choices. 2001 Dec; 23.HIV/AIDS is the most serious epidemic confronting the world. Since its first appearance some 20 years ago, countries have struggled to come to grips with its immense impact on every aspect of life. To date an estimated 60 million people globally have been infected with HIV/AIDS. After years of denial and inadequate activity at all levels and regions, a coordinated international effort is now led by the United Nations, from the highest level onward: the UN Secretary-General has made the fight against HIV/AIDS his personal priority; it is a preoccupation of the UN Security Council; and at a special session in June the UN General Assembly issued a Declaration of Commitment outlining specific leadership and coordination targets to be met over the decade. (excerpt)
Lancet Infectious Diseases. 2006 Jan; 6(1):14.Burma's Health Minister Kyaw Myint has sharply criticised a decision by the Global Fund To Fight AIDS, Tuberculosis, and Malaria to cancel grants worth US$98.4 million it approved in Nov 2004 and Jan 2005 to combat the three diseases in the country over the next 5 years. "Temporary restrictions on travel, that since have been relaxed, were not adequate reasons to cancel the grants", Myint said. He complained that the Global Fund did not warn his country of its intended action and warned that the termination would affect millions of people suffering from or at risk of HIV/AIDS, tuberculosis, and malaria in the country. Peter Newsum of CARE Myanmar believes the Fund's decision to cancel the grants will have a major impact on the work of organisations involved in combating the diseases in the country. (excerpt)
Journal, Indian Academy of Clinical Medicine. 2005 Oct-Dec; 6(4):268-274.At the Millennium Summit held at the United Nations (New York) in September 2000, 189 countries reaffirmed their commitment to working towards a world in which sustaining development and eliminating poverty would have the highest priority. Eight Millennium Development Goals (MDG) were adopted by a consensus of experts to measure progress in all the major areas related to the well-being of people. These included extreme poverty, education, health, gender equality, and the environment. All goals are interlinked, and efforts to achieve one goal will have positive spillover effects on several others. 18 Targets and 48 Indicators have been adopted to monitor the Eight Millennium Development Goals. Of these, 8 Targets and 18 Indicators are directly related to health. While many health indicators are "truly health indicators" such as prevalence and death rates associated with malaria and tuberculosis, some are related to critical factors for health such as access to improved water supply or dietary energy consumption (health-related indicators). India is committed to achieve the Targets under the MDGs by 2015. Incidentally, certain targets have been set under the National Population Policy 2000 (NPP-2000), National Health Policy 2002 (NHP-2002), National AIDS Prevention and Control Policy 2004, and the Tenth Five Year Plan. This paper compares goals and targets mentioned in these documents vis-a-vis selected Millennium Development Goals and Targets. This also highlights the current progress towards attaining the MDGs as well as the challenges ahead. (excerpt)
Lancet Infectious Diseases. 2005 Sep; 5(9):529.It is 5 years since the member states of the UN adopted the Millennium Development Goals (MDGs). Progress towards achieving the goals by the target date of 2015 will be reviewed at a meeting of the UN General Assembly on September 14–16. Of the eight MDGs, three relate—to a greater or lesser extent—to infectious diseases: goal 4, reduce the under-5 mortality rate by two-thirds from its 1990 level; goal 5, reduce by three-quarters from its 1990 level the maternal mortality ratio; and, most directly, goal 6, combat HIV/AIDS, malaria, and other diseases. Goal 6 is broken down into two targets: halt and begin to reverse the spread of HIV/AIDS, and halt and begin to reverse the spread of malaria and other major diseases (tuberculosis in particular). Sadly, for large parts of the world there is little prospect of these MDGs being reached by 2015. In 2003, under-5 mortality, to which pneumonia, diarrhoea, malaria, and sepsis are major contributors, was around nine per 1000 live births in high-income countries compared with 172 per 1000 live births in sub-Saharan Africa. Regionally, northern Africa, Latin America and the Caribbean, and southeast Asia have made rapid improvements since the 1990s, but at the current rate of progress the reduction in under-5 mortality worldwide by 2015 will be one-quarter rather than two-thirds. (excerpt)
Geneva, Switzerland, UNAIDS, 2004 Sep. 217 p. (UNAIDS/04.35E)This progress report summarizes the achievements of the Country and Regional Support Department in 2003 and presents selected highlights in greater detail. The first section outlines the strategic framework for action, Directions for the Future, the status of its implementation, the associated capacity strengthening of UNAIDS at country level, and challenges for 2004 and the next biennium. Text boxes in this section highlight “UNAIDS corporate tools” employed to implement the strategic framework. The second section reviews the Country and Regional Support Department’s efforts to translate global initiatives into results at country level. UNAIDS is involved in numerous global initiatives, three, which required particular involvement of UNAIDS resources at country level, are highlighted here. The third section reviews regional progress towards implementing the strategic framework for action. The examples cited, whilst not being an exhaustive review of country work, illustrate how UNAIDS has worked as a catalyst for national AIDS response. This report concludes with a collection of two-page country situation and progress summaries from 70 of the 134 countries with the UN Theme Groups on HIV/AIDS. (excerpt)
Global HealthLink. 2003 Sep-Oct; (123): p..On July 21, 2003, Dr. Jong-Wook Lee took office as director-general of the World Health Organization (WHO). In a world where emerging threats to global health are becoming increasingly encompassing, the individual at the helm of the pre-eminant health organization must be recognized as a major player on the world stage. In his inaugural address to WHO staff, Dr. Lee outlined his vision for the coming years of his tenure. Simply stated, he believes that WHO's work must be guided by three principles: doing the right things, in the right places, in the right way. Foremost among the 'right things' is a scaled up effort to fight HIV/AIDS to be led by a new HIV/AIDS leadership team with a mandate to develop a strategy for ensuring achievement of the "three by five" goal, i.e., providing 3 million people in the developing world with antiretroviral therapy by the close of 2005. WHO departments working on the three major infectious diseases - HIV/AIDS, tuberculosis and malaria - will be unified into one cluster that will be able to work effectively with the Global Fund. Additional 'right things' articulated by Lee include expanded attention to child and maternal health, noncommunicable diseases, tobacco control, nutrition, violence, and mental health as well as the eradication of polio. (excerpt)
Journal of the Pakistan Medical Association. 2004 Apr; 54(4):175-181.Objectives: There are two objectives: (a) to clearly articulate the Millennium Development Goals (MDGs) adopted by the United Nations in 2000 and their implications for developing countries like Pakistan; and (b) to critically review the challenges faced by Pakistan in achieving the health-related MDGs. Methods: A critical review of secondary data and information generated primarily by multilateral agencies and United Nations organizations. Results: The MDGs represent a global consensus on the broad goals of development to be achieved by 2015. Of the eight Millennium Development Goals, three are specifically health related - reducing infant (under-5) and maternal mortality; and combating HIV/AIDS, tuberculosis, malaria and other significant communicable diseases. According to various studies, many developing countries will not achieve the MDGs without concerted efforts and commitment of additional resources. Like many other developing countries, Pakistan is also faced with an enormous challenge in reaching the Millennium Development Goals and targets set by the United Nations. For Pakistan, perhaps the most challenging MDG is that of reducing "by three-quarters the maternal mortality ratio." Maternal mortality is so intertwined with other "social" factors - including the status of women - that a comprehensive holistic approach is required. Conclusion: In order to achieve the MDGs, Pakistan would require a fundamental shift in its policy and strategic directions. Along with allocation of significant additional resources for health, it needs to review and reprioritize the use of existing resources, focusing more on primary health care. Pakistan must also adopt a holistic integrated approach that views health, education, and other social sector development as intrinsically interrelated and interwoven. Without such an integrated approach, achieving the health-related MDGs is likely to remain illusive for Pakistan. There is a critical need to foster a healthy debate on the health-related Millennium Development Goals in Pakistan so as to inform and, hopefully influence, public policy. (author's)
Population 2005: News and views on Further Implementation of Cairo Program of Action. 2003 Sep; 5(3):14.The Joint United Nations Program on HIV/AIDS (UNAIDS) and the Global Fund to Fight AIDS, TB and Malaria signed a Memorandum of Understanding (MOU) August 4, 2003, to reaffirm their mutual engagement to strengthen the global response to the three epidemics. The MOU outlines the complementary strengths and roles of both partners in reducing the severe impact of AIDS, TB and malaria on communities in developing countries. It recognizes the Global Fund as a critical financing mechanism to scale-up national programs and UNAIDS as a key source of strategic analysis, policy advice and technical expertise to help countries access and use the resources of the Global Fund. (excerpt)
Bulletin of the World Health Organization. 2003 Nov; 81(11):777.During the last quarter-century or so there has been a revolution in both health and information technology. For the globe as a whole we have seen tremendous strides made in life expectancy and disease control, together with an explosion of information technology and techniques. Humanity now has the potential to make all existing health knowledge available simultaneously to the entire population of the planet. By no means everyone has benefited from the overall trend of increased life expectancy, however, or from that of increased knowledge and its communicability. This gap goes beyond the notion of the “digital divide”. It is a “knowledge divide”, in which large sections of humanity are cut off not just from the information that could help them but from any learning system or community that fosters problem-solving. (excerpt)
Lancet. 2002 Oct 12; 360(9340):1108-1110.This paper reports on the organization and administration of WHO under the management of Director-General Gro Harlem Brundtland. It describes the three broad categories of the work of WHO and the several areas that are considered to be organization-wide priorities for WHO.
AIDS WEEKLY. 2000 Sep 11; 18.Close to half the deaths in developing countries are due to infectious diseases, of which AIDS, tuberculosis (TB), and malaria are the biggest killers, according to the WHO. These 3 diseases infect over 300 million people and kill nearly 5 million in developing countries every year, WHO director-general Dr. Gro Harlem Brundtland said August 28, 2000, at the opening of a week-long gathering of the organization's Africa regional committee. “They penalize poor communities, as they perpetuate poverty through work loss, school dropout, decreased financial investment, and increased social instability at staggering social and economic costs,” Brundtland said. Delegates from 46 countries and representatives of major international bodies met to review health plans and work out new strategies for the continent. Brundtland urged action to curb infectious diseases, which account for about 45% of deaths in developing countries. AIDS, TB, and malaria are behind about half of those deaths, she said. AIDS is the biggest killer in Africa today, accounting for more deaths than the continent's endemic warfare or malaria. About 2 million Africans died of AIDS in 1999. Brundtland drew hope, however, from recent commitments made by the European Union and the Group of 8 industrial powers to fight to reduce the toll of TB, malaria, and HIV/AIDS. “We are on the brink of seeing real and substantial gains for the health of the poorest”, Brundtland said. “We are seeing a change in perceptions. Health is big news. Health is accepted as a central and necessary element in reducing poverty and ensuring economic growth and social progress.” She also drew attention to mental health disorders and tobacco-related diseases, which she said “will seriously challenge health care systems in the near future.” In October, the WHO plans to start work on a tobacco treaty for its 190 member countries. The treaty will seek to prevent the sale of cheaper, smuggled cigarettes and share anti-smoking campaigns and education materials with developing countries--where about 70% of smoking-related deaths occur. (full text)
AIDS ANALYSIS AFRICA. 1995 Dec; 5(6):6.A rebuttal is made to an article by Stuart Derbyshire criticizing the World Health Organization (WHO) for inflating AIDS figures. In essence, the article argues that AIDS in Africa is not as serious as the press, the WHO, and statistics make it appear. The HIV/AIDS epidemic is one of a number of serious problems facing Africa; furthermore, the apocalyptic predictions of massive increases in mortality and the collapse of societies made in the 1980s have not come to pass. However, Derbyshire notes that seroprevalence surveys were used to predict AIDS mortality, and this does not bear any resemblance to the actual recorded cases. It is known that cases in Africa are totally underreported. The WHO data show that some African countries have not updated their figures for 3 years. In recent years, data have become available showing a definite increase in mortality in young adults and this can only be explained by the increase in HIV/AIDS. The increase in morbidity and mortality from other diseases may be linked with HIV/AIDS. This is proven in the case of tuberculosis and may also account for some of the malarial morbidity. In some countries the level of HIV prevalence in the young adult population appears to have leveled off at lower levels than expected (5%), in others it has reached higher levels (30-40%). How the HIV epidemic progresses and has an affect on the population is determined by many social, economic, and political factors. The impact of the epidemic will be felt for many more years, but African societies are quite resilient. This article is right to question the perception of HIV/AIDS as the most serious problem facing Africa and Asia tomorrow. However, its importance should neither be underestimated nor should the other health and economic crises facing Africa be ignored.