Strength and CourageOne of the men wanted to speak, and Razia Naeem Khliqi inclined her scarf-draped head and leaned toward him. His tired eyes spoke of pain, but his voice was steady. "The women in our village," he said softly, "are dying."The anguished words of this young man, a volunteer Community Health Worker in the village of Shekh Ali, Parwan Province, are the reason Management Sciences for Health (MSH) is in Afghanistan.

Could people become immune?A paper by Dr. Malcolm Bryant of Management Sciences for Health was presented at the American Public Health Association Conference in San Francisco last November. The topic of this provocative presentation was whether widespread resistance to antiretroviral agents is inevitable in Africa.Antiretroviral treatments provide hope to people infected with HIV/AIDS in Africa and around the world. However, this treatment requires an absolutely accurate prescription coupled with an adherence by the patient to a prescribed regimen.

Tanzania is officially committed to providing medicines free of charge through the public sector, but public facilities regularly have gaps in stock. In addition, approximately 75 percent of all Tanzanians live in rural areas where essential drugs and basic medicines are often not available. Many people in need must spend much of their hard-earned money to buy medicines at duka la dawa baridi (private drug shops) in their communities, and the expense can be staggering. For example, a single course of adult treatment for mild pneumonia can cost 18 to 59 percent of a day's wages.