The British government named sexual health as a key priority for the NHS on Thursday, as new figures showed another rise in HIV infections.

Public Health Minister Caroline Flint said the government was determined to tackle the problem of rising sexually transmitted infections in Britain.

"That is why we have committed over 300 million pounds to modernize sexual health services as well as making sexual health one of the seven key national priorities for the NHS next year," she said in a statement.

The government had ordered a review of the NHS's key priorities, reducing them from the current 10 to seven, prompting fears among doctors that sexual health might fall off the priority list.

"The UK is facing a crisis in sexual health," British Medical Association Chairman James Johnson said in a letter to Health Secretary Patricia Hewitt last month.

"Meeting current waiting time targets is currently impossible. Although the target time is 48 hours, the reality is fewer than 50 percent of patients benefit from these timescales," he wrote.

"Those who fear they might be infected are unlikely to refrain from sexual activity while they wait for a clinic."

The Health Protection Agency said on Thursday the number of people in Britain being diagnosed with HIV continued to increase last year, taking the total living with the condition close to 60,000.

The agency forecast that over 7,750 new diagnoses of HIV infection would be recorded for 2005, when all data was complete, a rise of 6.5 percent over the previous year.

It said the rise was mainly due to a continuing increase of cases among homosexual men, which the agency forecast would jump to around 2,450 compared to 2,185 in 2004.

Other sexually transmitted diseases have also been rising in Britain, with cases of chlamydia, which can cause infertility in women, tripling over 10 years.

Six-month-old Matthew Coetzer bounces on his mother's knee. The bubbly blond and blue-eyed child is ready for his next meal of breast milk.

But Matthew's mother is not just feeding her own son.

In the family refrigerator are bottles of frozen milk, donations for a "bank" designed to bring the benefits of mothers' milk to orphans and sick children caught up in South Africa's devastating HIV/AIDS epidemic.

"It's a really important contribution that I can make, with minimal effort," 31-year-old Karen Coetzer said in her upscale living room in the port city of Durban, where the Ithemba Lethu milk bank has enrolled around 100 new mothers as donors.

Ithemba Lethu's milk bank, founded five years ago, has won widespread praise as an effective, grass-roots response to the AIDS crisis in South Africa, where an estimated 5 million people, or one in nine of the population, are HIV-positive.

The programme reaches across racial and economic lines in a country which, more than a decade after the end of apartheid, is both deeply polarised and increasingly overwhelmed by the extent of its AIDS crisis.

Donors to the milk bank are mostly white. The recipients, infants who have lost mothers to AIDS or who have been infected with HIV sometimes during nursing, are primarily black.

But the women involved with Ithemba Lethu say race is beside the point. "I think we need to start looking past that," said another mother, Liezel Roome, who donates to the milk bank and has adopted a five-month-old black baby boy herself.

"This land is in crisis, and this is one way that the babies who are in need right now can be helped."

"I HAVE A DESTINY"

Ithemba Lethu, which means "I have a destiny" in Zulu, was formed in 2001 when Anna Coutsoudis, a professor of paediatrics at Durban's University of Natal, was working with HIV-positive orphans and noticed one who was particularly malnourished.

Coutsoudis asked a friend who was nursing her own child for a donation of breast milk, and saw an immediate improvement.

With a grant from the United Nations Children's Fund, the bank was born. UNICEF officials say the bank could be a model for South Africa, where anti-retroviral (ARV) drug treatment for HIV-infected mothers is only now being widely introduced.

Coutsoudis says the bank provides babies with the important, immune-boosting power of mother's milk and prevents the transmission of HIV and other blood-borne diseases.

"We take milk only from healthy women, but as an extra safeguard we always pasteurise the milk as well," Coutsoudis said, demonstrating the pasteurisation machine the group uses.

"It is one of the few programmes which is trying to be innovative and break conventions. We know that these things can work. They won't work everywhere, but they can," said Marinus Gotink, chief of health and nutrition at UNICEF South Africa.

The milk from the bank is used mostly to feed the five AIDS-affected children the group cares for itself. When supplies permit, breast milk is distributed to other children's homes.

"As a nurse I know that breast milk-fed babies do very, very well," said Marian Loker, a nurse who runs the Lily of the Valley home which sometimes gets breast milk from the programme.

Gotink said the ultimate goal was to see that babies are breast-fed by their own mothers, something that could become possible as more HIV-positive mothers get ARVs which reduce the threat of transmitting the virus through breast-feeding.

In the meantime, Ithemba Lethu workers fan out around the Durban area collecting safe milk from dozens of nursing women.

BREAST IS BEST?

Mother-to-child transmission of the HIV virus -- during pregnancy, childbirth, or through breast-feeding -- is a painful part of South Africa's AIDS crisis and has led to some concern over Ithemba Lethu's focus on breast milk.

Olive Shisana, the head of South Africa's Human Sciences Research Council and a leading HIV/AIDS researcher, said studies had shown 60 percent of South African mothers breast-feed for longer than 12 months -- increasing the possibility that those who carry the HIV virus may pass along the infection.

While Ithemba Lethu's milk is safe, the idea of encouraging people to "share" breast milk or downplaying the value of infant formula is problematic, she said.

"Using somebody else's milk, in a society where we have so many communicable diseases, presents a challenge. I'm not sure whether this is a good idea or not," Shisana said.

Other critics of the programme say that donating breast milk outside of the family runs against African traditions.

But at Johannesburg's huge Chris Hani-Baragwanath hospital, the idea of safe milk banks got enthusiastic support from both new mothers and nursing staff.

"I don't think it has anything to do with cultures or traditions," said Nonhlanhla Monaheng, a consultant for new mothers at the hospital.

"It is humanity more than anything else. It is about helping each other in the difficult times that we are living in. It is about sharing what God has given us, and that is breast milk."

Microsoft Corp's founder Bill Gates pledged $900 million to fight tuberculosis on Friday, kick-starting a $31 billion funding drive against a disease which kills one person every 15 seconds.

Tuberculosis has reached alarming proportions in Africa and other poor countries, where co-infection with HIV/AIDS makes a deadly combination.

"This is a very tough disease. It is going to take all of us -- private sector, the pharmaceutical companies, philanthropy and governments in countries that have the disease -- to participate as well," Gates told reporters at the World Economic Forum in Davos.

Nigerian President Olusegun Obasanjo and British finance minister Gordon Brown called on world leaders to back the new World Health Organization action plan, which aims to treat 50 million people and prevent 14 million deaths worldwide over the next 10 years.

WHO believes the project can break the back of tuberculosis globally but full implementation would cost an estimated $56 billion over the next decade, including $47 billion for controlling the disease and $9 billion for research into new drugs and vaccines. That represents an overall increase of $31 billion over currently projected funding.

Marcos Espinal of the WHO said the first goal was to increase drug provision, since tuberculosis -- which is spread by coughing and sneezing -- was a curable disease in the vast majority of cases.

Most of the 2 million people who die of it each year live in the developing world.

New therapies are badly needed, too, because strains of tuberculosis are now circulating which are resistant to existing drugs, while the only vaccine available does not work very well.

Espinal said scientific research was now starting to deliver results, with a total of 27 new TB drugs in development and four vaccines in early-stage clinical trials.

Brown intends to put the case for new cash to fight the disease to next month's meeting of G8 finance ministers in Moscow. "If 2005 was the year of commitments, 2006 must be the year of delivery," he said.

"That's why, when the G8 finance ministers meet in Moscow in only a few days time, I will put on the agenda how we can meet the commitments to fund this specific plan."

Brown also said he would propose to the G8 ministers expanding a debt relief agreement made last year to some of the world's poorest nations.

Britain on Thursday pledged 41.7 million pounds ($74.43 million) to tackle tuberculosis in India.

When Botswana first offered free AIDS treatment, health authorities in one of the world's most infected countries braced for a rush of patients. It did not happen.

It turned out that most people were so afraid of the deadly disease, and the frequent social ostracism, that they did not want to know if they were infected.

That reluctance to seek help in one of the few African nations able to provide it prompted a radical rethinking of how testing is done here. Now, HIV tests are offered as a part of any medical visit.

In most places, patients are left to ask for a test themselves, then put through extensive counseling to prepare them in case HIV infection is found. But despite decades of education campaigns, the World Health Organization estimates less than 10 percent of infected people in the African countries at the epicenter of the AIDS pandemic realize they have the virus.

The decision of this southern African nation to start routine testing initially caused alarm among international health advocates, who worried that patients' rights to confidentiality and informed consent would be compromised.

"I think the first right of a human being is to be alive. All other rights are secondary," counters Segolame Ramotlhwa, operations manager for the national treatment program known as Masa, or New Dawn.

He argues that confidentiality was being confused with secrecy, making doctors reluctant to even suggest testing for a disease that has infected more than a third of Botswana's adults.

Doctors here believe pulling patients aside for special counseling is intimidating and helps fuel the stigma that keeps patients from seeking help.

"In fact, we found that people who had not made their minds up quite often were definitely against it once the pretest counseling was done," said Dr. Howard Moffat, medical superintendent at Princess Marina Hospital in the capital, Gaborone.

"I think the medical profession itself ... played a major role in creating this fear of AIDS and this quite irrational reluctance to be tested."

Since the beginning of 2004, Botswana has treated HIV tests like any other medical procedure. Patients have the option to refuse, but doctors say most don't. They estimate up to 35 percent of the country's 1.7 million people now know their status.

If the test proves negative for infection, a health worker delivers a brief message on the importance of staying that way. If the test is positive, the patient gets help to manage the condition and treatment when needed.

Most people see a doctor only after their symptoms become severe, by which time it may be too late. It takes three to four times more resources to save someone who arrives on a stretcher than someone who is still on their feet, Ramotlhwa said.

When Kelatlhilwe Segole was pregnant, she was not offered an HIV test and unwittingly passed the virus to her 7-year-old daughter. Both are now in treatment, but her husband refused to be tested until he was in a wheelchair.

"I kept telling him, he will die because of not knowing his status," Segole, a fragile-looking 27-year-old, said as she waited in a daylong line for her medicine.

WHO and UNAIDS now endorse routine testing in all HIV-prevalent areas where AIDS drug "cocktails" are available.

Much of the emphasis on voluntary testing and counseling came from AIDS' early association in the United States with gays.

That gave the disease an added taint in Africa, where homosexuality is widely taboo. But AIDS is overwhelmingly a heterosexual disease in Africa, home to more than 60 percent of the world's estimated 40 million infected.

Life-prolonging medicines that have turned HIV into a manageable chronic condition in wealthier countries remain out of reach for all but a handful on this continent. The drugs are expensive, and most countries lack the medical staff and infrastructure to dispense them widely.

A diagnosis of HIV often is a death sentence, experts say. Last year alone, 2.4 million people died of AIDS causes in sub-Saharan Africa.

Botswana was the first country in Africa to offer free medicines to all who need them in 2002, and the government says half the estimated 110,000 people in immediate need are being treated.

Rights activists agree on the urgency of reaching the other half. But they worry that many people consent to an HIV test without being prepared psychologically, noting there is a cultural reluctance to question doctors.

A study of prenatal clinics in Botswana's second city, Francistown, found 90.5 percent of women consented to HIV tests in the first three months of the new policy, compared to just over 75 percent in the last four months of the system requiring patients to volunteer for a test. Many of those women, however, failed to return for their results.

Christine Stegling, of the Botswana Network on Ethics, Law and HIV/AIDS, believes testing numbers are going up because people are starting to see the effects of treatment, not just because they are offered tests more often.

The new approach is also more likely to reach women, who are more frequent visitors to health services because of pregnancies. Men continue to be underrepresented in Botswana's treatment program.

"At the moment it seems like a numbers game, a total drive to get people to know their status. The question is then what?" Stegling said. "I have a feeling that what is happening is health care providers are getting out of communicating meaningfully with their patients."

A group of European donors plans to replace funding worth millions of dollars that Myanmar is losing from the withdrawal of the UN-created Global Fund to fight disease.

"There is an urgent need to make sure that the programs in place (to fight the diseases) do not end," one European diplomat told AFP on Tuesday.

"A process is underway and it will require political decisions, but we have high hopes as this project does not conflict with the EU Common Position" on Myanmar, the diplomat said, speaking on condition of anonymity because of ongoing talks on the issue.

The European Union has suspended most of its aid to Myanmar as part of sanctions to try to force democratic reforms, but it makes exceptions for projects to improve the health of the country's poorest people.

The Global Fund announced its pullout in August after earlier agreeing to give 98.5 million dollars over five years to battle AIDS, malaria and tuberculosis -- diseases that are prevalent in military-ruled Myanmar.

The Global Fund says it is leaving because of restrictions imposed by the junta, but diplomats say it also faced significant pressure from a handful of influential US lawmakers who oppose any compromise with the military regime.

A UN official, speaking on condition of anonymity, said banning programs to fight the three diseases is a "death sentence" for many in Myanmar.

The new donor group initially includes the European Commission, Australia, Britain, the Netherlands, Norway and Sweden, but other countries could join, the diplomats said.

The group has already held talks on the proposal with the Myanmar government, the political opposition and civic groups, they said.

Myanmar suffers one of the worst AIDS epidemics in Asia, posing a threat to the region as it spreads, according to the United Nations. Some 31 percent of prostitutes have HIV while nearly 38 percent of injecting drug users have the virus, according to UN estimates.

The country also has one of the world's highest caseloads of tuberculosis, with 97,000 new cases detected each year, while malaria is the nation's leading cause of illness and death.

The donors want to create an alternative system for funding health programs, while sticking to the safeguards established by the Global Fund to ensure the money does not directly support the military regime and that aid workers are free to travel the country.

Like the Global Fund funding, the new program would also give priority to local authorities and release new funding based on the results achieved in the projects, the diplomats said.

When the Geneva-based Fund announced its pullout, it blamed the junta's restrictions on movements of aid workers and limits on imports of medical supplies.

But diplomats said the withdrawal was equally due to a US political lobby that has the support of key lawmakers who want to push for regime change rather than compromise with the generals.

The UN Development Program (UNDP), which manages the Global Fund's money in Myanmar, has secured stopgap funding so that the existing programs can continue working until July, the UN official said.

This is in hopes of allowing a smooth handover when the new donors take over.

The donors met Myanmar officials on January 19 to discuss the project, diplomats who attended the meeting said. The European Commission plans to send a group of experts next month as they prepare the new scheme.

Myanmar has been ruled by the military since 1962 and is the target of western sanctions aimed at pressing for democratic reform and the release from house arrest of opposition leader Aung San Suu Kyi.

The United States has taken a hard line against dealing with the regime, but other nations in Europe are now pushing for humanitarian initiatives to ease the plight of Myanmar's people.