I read with much interest the different opinions ('Aids alarm,' #311), including Rajiv Kafle's piece on the current 'alarm' in Nepal. Indeed, your supplement was the only one that I e-browsed in the entire Nepali media to coincide with the 16th International AIDS Conference in Toronto. Bina Pokhrel's interesting view that the government lacks further financial and technical absorption capacity might be more human resource-related and can be solved. For instance, the National Centre for AIDS/STD Control certainly needs periodic strengthening in its behaviour change interventions, communications outreach and training programs. It is also true, as Shyam Mishra, suggests that programs must be rolled out more to the field.

But perhaps the following is a more acceptable answer for Nepal. Anders Nordstrom, acting director-general for the World Health Organization, recently said at Toronto, "The most important area to ensure success in achieving universal access is a skilled and motivated workforce. No improvement in financing or medical products can make a lasting difference to people's lives until the crisis in the health workforce is solved."

Nepal's current limited HIV/AIDS-focused health workforce needs further training and encouragement backed by apolitical national commitment. Donors need to concentrate on how the government can make the national strategy truly workable given its limited 'dead' timeframe.

The Toronto AIDS Conference might have helped strengthen the global response, but in my view in Nepal we still to need to work collectively to activate a more human national response, the gist of Rajiv Kafle's view.

Surya B Prasai,
Toronto