Quick action is needed to reduce the human cost of broken promises. Additional investment is urgently needed in public health services, in developing countries, and in the Global Fund to Fight AIDS
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I first met Zackie Achmat at a rather formal dinner that was being held in honor of Nelson Mandela under the canvas of a grand marquee tent, with elaborately laid out table arrangements, ladies sashaying in evening gowns and gentlemen dressed in evening suits.

One person stood out from the assembled gathering, wearing a black T-shirt, with "HIV positive" strikingly emblazoned in contrasting white lettering across his chest.

It was Zackie...of course.

In South Africa, and in international HIV activist circles, his name is somewhat legendary. His campaign to secure treatment for people living with HIV and AIDS has taken him to court, and led him to publicly and personally refuse antiretroviral (ARV) medicine until it was made available to all those who needed it in his country.

Needless to say, he won his case. His work as founder of the Treatment Action Campaign (TAC) has made a massive difference to the 5.2 million people living with HIV in South Africa today. Our chance encounter in the Garden State of George is the reason why I became a TAC campaigner and supporter.

In 2003, inspired by Zackie and the work of TAC, I launched the SING campaign to support women and children who are infected or affected by the virus. Later, I became an Oxfam Global Ambassador to support their work calling for Governments to deliver the $10bn a year needed for universal HIV and AIDS, prevention work, treatment and care.

In the last few years we have seen vast improvements. Infection rates are falling, and better access to medication has helped cut deaths by 10 per cent over the past five years. In Zambia, 50 times more people are receiving medication compared with six years ago, thanks to free distribution of anti retrovirals. In neighboring Malawi, the government provides ARVs to three-quarters of those who need them.

But progress has not been fast enough.

Across the world 2 million people died of AIDS-related causes last year, and fewer than half the 9.5 million people in need of ARVs receive them. The hardest thing to bear is that these are not inevitable statistics; they are the result of the rich failing to keep their promises to the poor. With the New Year a mere month away, the 2010 deadline set for universal AIDS treatment by world leaders when they agreed, the Millennium Development Goals will be missed.

Quick action however will reduce the human cost of these broken promises. Additional investment is urgently needed in public health services, in developing countries, and in the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has a proven record for saving lives.

With wealthy countries budgets under pressure as a result of the economic crisis, it now may not seem the most promising time to be asking for more resources. But the money found for bank bailouts shows what can be done in response to a crisis. Two million (mainly avoidable) deaths a year is certainly that.

More could also be done to make existing money go further.

Governments should pressure their domestic drug companies to sign-up to a patent pool for HIV medicines that would accelerate the development and bring down the cost of new treatments. It will take political bravery to make the case for extra investment, and take on the vested interests of pharmaceutical companies.

But Zackie's courage and that of many more exemplary activists like him demand it.

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