I want to congratulate you, Prime Minister Blair, on the hard work that you and your team have put into the Commission for Africa's report.1 It is an honest document, probing gently but fearlessly into the reasons why so many endeavours in this great continent have failed. You emphasise the responsibility of African leaders to drive development from within Africa but at the same time make clear the responsibility of the richer countries to commit to serious partnership in the process, with the aim being Africa's development rather than their own. I am sure you don't need reminding that these principles will be difficult to put into practice, but I am hopeful that the report will be a template for action.

When I heard about the commission last year I tried to contact you, requesting that at least one of the commissioners be involved in health care. Maybe you were overwhelmed by advice, as my letters went unanswered. However, your report has touched on matters of health, with sections on HIV and AIDS, tuberculosis, and malaria. These diseases are of enormous importance and are already being tackled by many groups in Africa. I am not involved in HIV treatment myself, but many of my patients are infected by the virus and my wife is working in a palliative care project for dying children, most of whom have HIV or AIDS, so I know first hand of the misery and hopelessness in so many lives.

You also touch on the enormous need for healthcare professionals. I can echo this in surgery. At present Malawi, a country …