This paper presents a pilot project that investigates the possibility of producing biogas from a mixture of water hyacinth and fresh rumen residue – replacing firewood as a source of fuel – to meet the energy needs of a maternity facility in Niamey (Niger). The discontinuous-type installation (batch reactors) is made up of six digesters measuring 5 m3 each. The output during hot and cool seasons, 0.52 m3 and 0.29 m3 respectively of biogas per m3 of digester per day, has met the energy needs of the maternity facility, estimated at 8 m3 of biogas per day. The study revealed strong seasonal variations: output during the hot season is approximatively 1.8 times greater than it is during the cool season. Large quantities of water hyacinth, an invasive plant present in Niger since 1986, are manually harvested in aquatic environments. The project is run by a local NGO, the Groupe d’Initiative pour les Energies Renouvelables (GIER), and supported by UNICEF and the Niger Basin Authority. The duration of the project is 8 months.

Medical treatment for people living with HIV/AIDS started in Mali as early as 1997 thanks to civil society. The national response was officialised by the adoption of the Malian Initiative for Access to Antiretroviral Therapy (Initiative Malienne d’Acces aux Antiretroviraux IMAARV). In 2004 ART, drugs against opportunistic infections and basic biological monitoring were made available free of charge by decree. In 2005, decentralisation of health-care to regions and circles became one of the main thrusts of the national strategy for the fight against the pandemic. Sub-Saharan African countries are making significant efforts to provide full geographical coverage of their national territory. It is in this “scaling-up” context that the Solthis NGO (Solidarite Therapeutique et Initiatives contre le Sida) began cooperating with Malian actors to extend access to quality treatment for patients living with HIV/AIDS in the city and region of Segou. Based on a developmental approach, Solthis opted for continuing in situ technical support for national actors in the fight against AIDS. Thanks to the daily presence of a team “in the field” Solthis devotes a large part of its activities to capacity-building for health-care workers through an exchange of medical and scientific expertise. Efforts were also made to improve health-care workers’ working conditions and to make various tests and drugs accessible to patients infected with HIV. The initial aim was to encourage universal access to ART. Today, the Segou programme supported by Solthis has developed over 1,500 new treatments in the region. In addition, every PMTCT centre in the region offers prevention and treatment services to mothers and children. Today, the Segou region is an integral part of the IMAARV initiative as a decentralisation pilot project.

A Mobile Laboratory was developed for use primarily during the epidemic meningitis season in Burkina Faso. This report describes the Mobile Laboratory characteristics, its use to date, problems encountered and their resolution, and future directions. During 2004, the mobile laboratory intervention in three remote Burkina Faso districts experiencing meningitis epidemics led to more specific case management and led directly to vaccination of one district. However, in a second district, the intervention occurred too late to allow vaccination. During 2006, the Mobile Laboratory was used to conduct an emergency carriage study that for the first time occurred during the peak of a meningococcal serogroup A epidemic. This information is critical for the design of meningococcal conjugate vaccine schedules and vaccine approaches. During 2004-6, technicians in 11 district laboratories received training by Mobile Laboratory staff. Numerous problems with the initial prototype laboratory were identified, namely that the solar power cells could not provide enough energy to the refrigerator and incubator to maintain appropriate temperatures and having a single integrated unit required use of a separate vehicle for specimen transport. A second laboratory was developed during 2005-6 that used a generator or local energy source for power and that had a laboratory that could be detached from the vehicle. Currently the main limitation of the Mobile Laboratory is that it has not been integrated into routine Ministry of Health activities, limiting its use both during and between meningitis seasons.