Advocacy is at the root of every piece of good news associated with HIV/AIDS: the creation of the Global Fund; the fact that anti-retroviral therapy, which was available only to the wealthiest a decade ago, is now prolonging the lives of close to two million of the people who need it in developing countries; the fact that South Africa’s government has finally abandoned its denialist position and begun rolling out an acceptable treatment plan....Examples abound of where advocacy has succeeded.

But the list of issues still in need of honest, tenacious advocacy far outnumbers any checklist of achievements.

Despite forward movement, the virus remains several steps ahead of us. That fact is evident each year when new and ever-higher numbers are released.  A deeply discouraging statistic was released for the first time in 2006: a full decade after anti-retroviral drugs were first approved, for every patient who initiated treatment, there were six new infections.

As the pandemic matures, it raises new and more complex issues: the questions surrounding HIV testing in environments where human rights aren’t protected; achieving universal access to drugs in resource-poor settings; the refusal of the G8 to commit the resources needed and then stick to those commitments; severing the links between the spread of HIV and violence against women, TB co-infection and the still-neglected rights of the disabled; accelerating the world’s inexplicably slow embrace of simple, effective prevention techniques including male circumcision; protecting infants during labour, delivery and breastfeeding; vitally important harm reduction strategies for injection drug users; keeping sick parents alive (and hence, keeping the numbers of orphans as low as possible); providing microcredit to women in ways proven to reduce intimate partner violence; and involving commercial sex workers in breaking the chain of transmission — to name just a very few.