In March 2003, personnel from education ministries in the four countries in the UNESCO-Nairobi cluster grouping (Burundi, Kenya, Rwanda and Uganda) met for the first cluster consultation on HIV, AIDS and education. There was general consensus at the meeting that Ministries of Education need to pay greater attention to issues of management, care and support, coordination, and protecting the overall quality of education. The second consultation, held in Kampala in June 2003, addressed itself to the role of Education/Teacher Service Commissions and dealt extensively with issues relating to teacher management and the management of the teaching service. The third consultation, which was held in November 2004, concerned itself with the impact of HIV & AIDS on tertiary level education and how institutions should respond. The consultation that we are presently attending in Mombasa (June 2005) is the fourth in the series. Again it focuses on Education/Teacher Service Commissions (TSCs). The purpose of this consultation is to monitor the progress that had been made in the two years since the Kampala meeting and in the light of more recent developments in the field of HIV & AIDS to ensure that plans and proposals make provision for the challenges that the epidemic poses for TSCs. The Kampala consultation identified four priority areas to which TSCs should give special attention: 1. Employment policy and regulations. 2. Staff protection and prevention programmes. 3. Sick leave and absenteeism management. 4. Employee assistance programmes. The remainder of this paper extends the Kampala discussions by considering eight challenges that HIV & AIDS are seen as posing for TSCs. In doing so, it also takes account of some of the major issues raised in the Kampala consultation. The challenges to be considered are: 1. The impacts of TSC policies and practices on the epidemic. 2. The role of antiretroviral therapy. 3. Ensuring teacher quantity and the quality of learning. 4. Absenteeism and quality provision. 5. Ensuring adequate inservice training. 6. Staffing schools in remote and poor communities. 7. Partnerships with teacher unions. 8. Getting to grips with the epidemic.