There is now an acknowledged burden of AIDS and the HIV in Nigeria. In treatment centres, AIDS-related disorders account for up to 40% of admissions, while many communities have recorded regular losses within the last five years. In December 1999, the federal government announced that 2.9 million people (or 5.4% of the Nigerian population) were already infected by HIV. An important aspect of HIV/AIDS programmes is the care of persons living with AIDS (PLWA), both in curative centres and in communities. Based on operations research of a STD/AIDS Management Project, this paper examines acceptance of PLWA in communities in Southern Benue State, an area of high prevalence. From interviews with PLWA, their family members and others in the communities, it was found that the level of stigmatization is high and acceptance of PLWA is low. These reactions stem mainly from the fear of contracting 'the disease that has no cure', believed to be transmittable through any form of physical contact. Based on beliefs, which are further reinforced by the local terms for AIDS, some suggested that PLWA be eliminated before they infect others. These findings suggest that the challenges of AIDS control programmes include coming to terms with the epidemic and fostering more acceptance for PLWA and, above all, changing the current perception of HIV/AIDS from a personal to public health problem. The challenges are daunting but urgent, particularly because Nigeria's HIV/AIDS epidemic is reaching an explosion phase and more care will be provided at home.

The health care system in Nigeria remains topical because of concerns over unremitting health outcomes, such as maternal and infant mortalities and frequent epidemic outbreaks, and more recently because of regular strikes by health workers. The strikes arise mostly from disputes between medical doctors and other health workers over a range of issues, including salary levels and emoluments, leadership of teaching hospitals, and appointment of the Minister of Health. Other health workers, who allege that doctors are favored in the system, have formed Joint Health Sector Unions to confront the doctors. Both groups have frequently engaged in strikes such that, within the past decade, there has always been a strike or the threat of a strike, a situation that causes disruption of health care services. Two presidential commissions have been instituted, to no avail. With the allegations of favoritism, only government even-handedness in more carefully delineating the areas of inclusion and exclusion in accordance with available legislations may stem the rising tide. Until solutions agreeable to both parties are found, the health system and the Nigerian people will continue to suffer frustrations of avoidable disruption of services.

Developments in health are easily among the best known human development indicators. Comparisons of life expectancy, infant mortality, access to safe water and similar data indicate the positions of individual countries. The political and economic processes which these indices reflect, or which inform the nature of health policy, are often not as clear or visible. These structural factors are either frequently ignored or mentioned only in passing, as illustrated in a recent paper published in this journal on the private medical enterprise in Nigeria (Ogunbekun et al. 1999). According to the authors, the generally low quality of public health services and high user fees have combined to make private medicine the 'unavoidable choice' of Nigerians. They identify benefits of private medicine as higher technical efficiency and contributing to fill the gap created by inadequate public sector services and to medical training. This paper argues that these claims are exaggerated, and that the authors seem to ignore Nigeria's political and economic processes, the health seeking behaviour of Nigerians, as well as the prevailing causes of morbidity and mortality. It is suggested that whereas the contributions of private medicine are significant, there are also several limitations, some of which originate from its for-profit raison d'être. The ultimate aim of health development must include improved access to services and better health status for the majority of the people. Without any form of public supported programme of payments in Nigeria, these objectives are circumscribed, especially with high fees in the private system. It is concluded that while private medicine will continue to be available for those who can afford it, it is unlikely to provide solutions to Nigeria's morbidity and mortality problems, particularly in relation to epidemics such as the growing burden of HIV/AIDS.

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Drama and video are effective tools for stimulating reflection and research on violence. This article describes a research process which tried to understand expressions of identity, constructions of citizenship and prospects for reducing future violence in northern Nigeria, where there have been many outbreaks of violence centred on religion and ethnicity. Researchers and local partners carried out a survey in several communities. They then used the survey findings to develop a drama which was performed in each community and which was followed by a facilitated debate. Participatory video was integrated at all stages. The research findings show that most people do not believe that the contemporary violence is a result of religion. Rather, they see religion as the organising platform. This analysis offers a more nuanced understanding of the conflict than merely labelling it ethno-religious.