Stephen Lewis: We must not be cowed by figures in the fight against Aids/HIV

I've been in this envoy role for just over two years. The issues related to the pandemic ebb and flow, but remain much the same - care, prevention, treatment, stigma, discrimination, gender, orphans, leadership. They all continue to reverberate, unceasingly, as we struggle to overcome HIV/Aids.

No one would dispute that the centrepiece of the debate is the quest for treatment. I recognise that the debate has controversial edges - witness the situation here in South Africa - but there's simply no denying that everywhere one goes on the African continent, everyone affected or infected by the virus is talking about or demanding treatment. The change, even in two years, is startling. Suddenly there is the recognition, especially among people living with HIV/Aids, that treatment is possible, that it should be affordable, that lives are prolonged, and that treatment brings hope.

I have had the opportunity of visiting a number of countries, all of which give credence to the powerful drive for treatment. If ever there were lessons to be learned, they are to be learned from Uganda. The country is obsessed with treatment and is pursuing it single-mindedly. They are not cowed by infrastructure. They are not cowed by human resource capacity. They are, quite simply, determined to keep their people alive. It's truly inspiring.

I have read a recent World Bank study, and what it says about the prospects for South Africa is nothing less than apocalyptic. For the bank to predict the possibility of a failed state of South Africa within three generations, based on the socio-economic fall-out from HIV/Aids, is astonishingly uncharacteristic. It must therefore be taken seriously.

Treatment is the current agenda. It will remain the current agenda until the agenda is met. As Nelson Mandela said: "It is an elemental matter of human decency, and history will judge where decency was wanting."