RT Journal A1 Gostin LO T1 INternational nurse migration and hiv/aids—reply JF JAMA JO JAMA YR 2008 FD September 3 VO 300 IS 9 SP 1024 OP 1024 DO 10.1001/jama.300.9.1024-b UL http://dx.doi.org/10.1001/jama.300.9.1024-b AB In Reply: Ms Lynch and colleagues draw attention to what I believe is the single most important challenge facing sub-Saharan Africa and other extremely poor regions. That problem is a generally weak public health and health care system that cannot meet the basic survival needs of the world's poorest and least healthy people.1 Although donor states and philanthropies care passionately about crumbling health infrastructures in poor countries, they do little to solve the problem and they unwittingly contribute to it.