Julia, 24, has three children and is one month pregnant with her fourth baby, but is adamant that she does not want to continue with the pregnancy. Julia participated in a pilot project to prevent transmission of the HI virus from mother to child (PMTCT) at the Primiero do Maio health centre, in Malhagalene, a suburb of Maputo, the capital. It began in June 2002 and is supported by the international medical NGO, Medecins Sans Frontier (MSF). One of the ongoing challenges is the stigma associated with the virus. Nurse dos Santos points to a box of consultation cards belonging to 28 of the women benefiting from the project. "The women ask me to keep their cards, so that their husbands or other family members do not see their status," she said.

Existing tools to control cholera may soon be supplemented with something new - mass vaccination with an oral cholera vaccine. The idea is being put to the test in a demonstration project in Mozambique by the World Health Organisation (WHO) in collaboration with the Ministry of Health, Médecins sans Frontières (MSF), Epicentre and the International Vaccine Institute. The vaccine itself has been available for ten years, but this is the first time it has been used so broadly to minimize the devastation of a cholera outbreak.