Antiretrovirals are coming to Africa: are you ready?

International agencies are beginning a rapid scaling up of antiretroviral distribution programs in Africa. Some are particularly looking for "faith-based organizations" (FBOs) as partners. The new initiatives may offer both unprecedented opportunities and some dangers for FBOs who wish to join in. The opportunities include increasing our capacity to provide not only HIV/AIDS care but other aspects of health care, and a potential for increased communication and cooperation between Christian organizations. The dangers include the likely widespread appearance of antiretroviral resistance; long term sustainability; negative impact on other aspects of HIV care and prevention; indirect costs to FBOs; corruption; encouragement of a culture of money and power, drawing FBOs away from their perceived missions; overextension; and harmful competition among FBOs. Organizations should be aware of the opportunities and dangers, and review their own calling and mission, before embarking on large-scale, externally-funded programs of ARV distribution.