Abstract

The scale-up of antiretroviral therapy is the most ambitious public health undertaking of our lifetimes. We are making history…

(Gonsalves 2008) When antiretrovirals (ARVs) first came on the market in the 1990s, they were exceedingly expensive; the cost of treatment was upwards of US $10,000 per year. ¹ These drugs were thus only accessible to those with high incomes or exceptionally good health insurance, and gay activist groups – notably the militant organisation ACT-UP – targeted pharmaceutical companies, insurance providers, and governments for changes in their home governments, rather than at the global level (d’Adesky 2004; Kramer 2003; Johnson and Murray 1988; Smith and Siplon 2006).