Telemedicine is a way to support health care delivery in remote areas. With this telemedicine project the Institute of Tropical Medicine, Antwerp (ITMA), intended to facilitate the introduction of antiretroviral therapy (ART) for patients affected by Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) in developing countries, providing training, distance support and education to healthcare workers located in those settings. In 4 years experience the ITMA Telemedicine service received 642 teleconsultations, from more than 35 resource-constrained countries. We believe that by giving to clinicians the opportunity to access support and clinical mentoring it is possible to lower the threshold for launching ART programs and impact the speed of the scaling up access to antiretrovirals in developing countries. KEY WORDS: Telemedicine, HIV/AIDS, antiretroviral therapy, low resource settings, developing countries, health care workers.

DREAM (Drug Resource Enhancement against AIDS and Malnutrition) è un programma ad approccio globale per curare l? AIDS in Africa avviato in Mozambico nel febbraio 2002 dalla Comunità di Sant? Egidio. DREAM è concepito per l'eccellenza. Eccellenza delle cure, della diagnostica, dell'organizzazione e dell'informatizzazione. Il programma ha avuto negli anni un? accelerazione esponenziale e ad oggi ha in cura oltre 45.000 pazienti in 22 centri sanitari diffusi in 10 paesi dell? Africa Subshariana. L? eccellenza delle cure e della diagnostica è resa possibile anche grazie alla realizzazione di 13 laboratori di Biologia Molecolare che eseguono di routine per ogni paziente la Carica Virale, la conta dei Cd4 oltre ovviamente a esami di biochimica ed emogrammi. L? elenco dettagliato dei centri di cura e dei laboratori è riportato nella cartina che segue.

The most critical distinction in this organizational logic is to be or not to be - in the network. Be in the network, and you can share and, over time, increase your chances. Be out of the network, or become switched off, and your chances vanish since everything that counts is organized around a worldwide web of interacting networks Although Castells [1996] may sound reductionist, the centrality of networks in contemporary world is widely accepted. This is increasingly important because networks? growth is not only geographical, it is taking place across disciplines and fields of activity, too. The improvement of health standards in Africa (and elsewhere as well) through information technologies cuts across many boundaries between medicine, politics, innovation, development and cultures. One of the bottlenecks in the development of effective healthcare systems (which also rely on health information systems, patient record systems, laboratory systems) is the centralized and fragmented nature of specific health care activities, lack of coordination, poor quality and use of information, and the complex nature of health organizational context. Poor focus on the development of local expertise and the tendencies of neglecting of social and organizational issues are cited as major factors contributing to the problem of ineffective implementation of computerized healthcare systems.

This paper is devoted on comparative analysis between three software solutions for autoimmune diseases from three countries ? UK, Spain and Bulgaria. Each of them has specific exploitation purposes. UK development BLIPS is a regular information system for current patients, Spain software Euro-phospholipids is prospective 10 year international project, connecting more than 20 countries, and Bulgarian solution ? Imunolog is retrospective database, with strictly defined purpose objectives ? to explore causes, treatment schemes, manifestations and reactions of all available patients in Bulgaria since 1960. It is elaborated a scheme for comparison of the developments with 31 parameters, results are presented both in graphical and textual regimen. The juxtaposition is initiated because of the necessity to popularize these scientific inventions,

Physicians and healthcare workers of poor countries can not often access to updated health and medical information they need, because their activities are mainly carried out in remote rural locations without electricity or structures of fixed-line phones. It stands to reason that in a large part of African countries mobile devices, such as mobile phones, PDAs and so on, could represent a solution into areas without electricity and connectivity in order to enable the information access and healthcare services delivering. This paper discusses of the e-health prospective in Africa. E-health systems and infrastructures are considered focal for the future of an efficient, safe and citizen-centred health care. It offers an exciting opportunity to reduce the growing health care inequity, which is particularly relevant in the African continent.