In South Africa, AIDS is a social and political crisis, not just a medical one, contends Hoosen Coovadia. In the past few years, as racially and culturally polarised South Africa has moved from apartheid to democracy, such programmes have proven particularly difficult. ''At the top, we currently have many political and social problems which have relegated issues like HIV/AIDS to the much lower provincial decision making levels,'' Coovadia says.

Coovadia, who will co-chair the XIII International AIDS Conference in Durban, South Africa in 2000, explains that in his country, AIDS has long been viewed as a problem of black people. "There is no question that there is political will, but with few good schools for black children and a wide income gap between white minority and black majority, AIDS has taken the back seat."

He reminds us that ''before 1994 we were all involved in the liberation struggle. There were many more pressing problems than HIV. Therefore no comprehensive prevention programmes to stop the spread of the virus were set."

The apartheid government did extend some HIV prevention strategies to black South Africans, but these efforts were resisted when they feared that condoms were intended simply to reduce the black population. So while everyone in South Africa knows about AIDS, so far this knowledge has not translated into behaviour, fuelling the continued epidemic.

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