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Life expectancy - a key measure of development - is already tumbling as a result of accelerating death rates in all sub-Saharan countries ranging from Angola to Zimbabwe.

Aids has now overtaken malaria and tuberculosis as the leading cause of death in Africa.

Attendance at Supervised Injecting Facilities and Use of Detoxification Services. Safer Injecting Facility Use and Syringe Sharing Among Injection Drug Users. American Journal of Drug and Alcohol Abuse Supervised injection facilities have a place in comprehensive HIV care models This study explored the concept of integrating supervised injection programming into an HIV focused care facility in Vancouver. The findings show that those most likely to receive care are the individuals engaged with treatment regimens similar to those provided at In Site.

Lancet Infectious Diseases 1-6 Changes in Public Order Reports that the opening of In Site appears to have lead to improvements in public order, including reduced public injection drug use and public syringe disposal. Canadian Medical Association Journal 11-4 Impact on Drug Related Crime Examines crime rates in the neighborhood surrounding In Site during the year before versus the year after In Site opened. Impact of a Medically Supervised Safer Injecting Facility on Drug Dealing and Other Drug- Related Crime. American Journal of Public Health In Site reduces strain on the health care system Specialized and relevant onsite care is proven to reduce ER visits and hospitalizations among local injection drug users.

American Journal of Preventive Medicine 6-30 Service Uptake Reports that Wood E, Tyndall MW, Qui Z, Zhang R, Montaner JS, Kerr T. Service Uptake and Characteristics of Injection Drug Users Utilizing North America's First Medically Supervised Safer Injection Facility. Wood 2008 Non-fatal overdose among a cohort of active injection drug users recruited from a supervised injection facility American Journal of Drug and Alcohol Abuse In Site does not promote drug use Responding to concerns that In Site promotes initiation into injection drug use, this study found that In Site users have been injecting for an average of 16 years, and that only 1 participant reported having first injected at the site.

American Journal of Public Health 0-3 Syringe Sharing Factors Reports that the use of In Site by injection drug users is associated with reduced syringe sharing. The report concludes that the benefits of In Site have not been offset by a rise in drug use.

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Unlike the infectious scourges of the past, which took their toll mainly on the very young and very old, Aids is devastating the most economically active members of the population, the young adults and skilled workers on which Africa's fragile economies depend.By next year the UN Aids Programme expects there to be 13 million Aids orphans.In Uganda, one of the first countries to experience an Aids epidemic, 11 per cent of children are Aids orphans - compared with a typical orphan rate of 2 per cent.In Zimbabwe, where one quarter of the general population is infected, between 40 and 50 per cent of pregnant women are HIV positive - threatening a further big increase in the number of orphans.

Teenage girls in Africa are the most vulnerable section of society, being six times more likely to be HIV positive than boys of the same age.

The worst fears of the 1980s are being realised in the Africa of the late 1990s.