Seven out of 100 adults are living with HIV/AIDS in Africa. This rate is substantially higher in Southern Africa, where sexual behaviour, high domestic violence, and illegal drug use are some reasons for higher infection risk. Limited access to treatment drugs and lack of effective educational campaigns to reduce risk of infection remain serious challenges. Unwillingness to speak out and inadequate commitment to addressing issues of power relationships between men, women and youth also hamper the response to the pandemic. Adopting more people-centred programmes that take sexual behavioural norms and cultural practices into consideration may help to break the pattern of the disease. Just as important, however, is treating those already infected with the disease.6

Malaria still accounts for the largest proportion of deaths especially among children on the continent. Part of the counter-strategy has been the distribution of insecticide-treated mosquito nets, which has increased tenfold since 2000. Curbing the spread of malaria is a complex challenge that calls for the involvement of often-ignored urban planners and management: building ventilated homes; ensuring communities are outfitted with appropriate drainage systems to avoid mosquito-breeding sites such as puddles and still water collected in garbage; and ensuring garbage collection and disposal is performed in a timely and efficient manner, among other measures.

At least 70 per cent of the 14 million people worldwide living with HIV/AIDS and tuberculosis (TB) – these diseases often go together – are in Africa. There, the number of new TB cases per 100,000 population (excluding those that are HIV-positive) nearly doubled between 1990 and 2003, from 142 to 274. Prevention and treatment efforts are being scaled up but more can be done to integrate programmes, especially in the context of the Global Fund to Fight AIDS, Tuberculosis and Malaria.