What are the most appropriate local health systems to deliver antiretroviral drugs (ARVs) in poor countries? Does direct observation help patients to take their drugs regularly and prevent drug resistance? Is this a feasible strategy for providing ARVs? What barriers prevent access to treatment of other chronic diseases such as TB? id21 Health's email discussion will provide a forum for a wide range of stakeholders to share their views on these and other important issues. Participants will include international and national policy-makers, health professionals, NGOs and researchers from diverse academic disciplines. The discussion report will be presented and discussed at the International AIDS Conference in Barcelona, July 2002.