While at the same time having to face the challenges of building democracies and institutions with capacity to cope with the regular demands of national development. I just returned from Malawi. But even with donor resources it is at this stage only half way financed. Without anti-retroviral therapy and without sufficient staff resources to provide care. There are obviously no universal prescriptions in the hard choices that individual countries face in shaping public policy.
All governments face similar dilemmas of priority setting for and rationing of public resources.
This also applies to actors in international development. The AIDS pandemic is extraordinary and cannot be met with a single set of responses. This is also why it gives us an extraordinary push forward to deal with the systemic aspects of poverty and its challenge to global and national governance. It challenges deficiencies in financing for development, both in terms of private and public resources, nationally and internationally. And they apply to all essential drugs, not only the anti-retrovirals.