In August this year an HIV-positive prisoner died at Westville correctional centre in South Africa’s KwaZulu-Natal province, a region with one of the highest HIV rates in the world. For Treatment Action Campaign (TAC) it was the last straw. The death sparked the launch of a TAC campaign demanding the dismissal of the South African Health Minister Manto Tshabalala-Msimang. Prior to the death, the TAC had been embroiled in a court case to force the Government to provide Anti-Retroviral (ARV) treatment to HIV-positive prison inmates at Westville. According to TAC General Secretary Sipho Mthathi: ‘Evidence shows a 40 per cent prevalence of HIV in prisons, which means you’ve got people either dying in prison without any proper care or people who go outside bringing HIV back to the population. It’s just crazy – one should never have had to remind the Government that you just do this [provide treatment] and don’t argue about it.’ The judgment in the Westville case ordered that barriers to treatment be removed, but the Government appealed. It was in this context that one of the 15 applicants in the case died. Mthathi was outraged: ‘The kind of negligence we saw in the prison system we felt was the exact same kind of negligence being displayed by the health ministry across the board.’ The spat was the latest between government and civil society over the provision of ARV treatment. With between 5.5 and 6 million South Africans HIV positive, TAC estimates that there are 800 AIDS-related deaths a day. Official health department figures claim that 175,000 people are currently receiving life-saving ARVs, just a fraction of those who need it. At the same time as the Westville case was unfolding, the 16th International Conference on HIV/AIDS took place in Toronto. Activists were furious at the South African Government’s exhibition in Toronto, including displays of beetroot and garlic, advocated by Tshabalala-Msimang as central to the fight against the epidemic. The South African Government was roundly condemned at the conference. UN special envoy to Africa Stephen Lewis denounced the South African Government’s theories as worthy of a ‘lunatic fringe’. The Westville case and the Toronto debacle caused the TAC to embark on a campaign to highlight the slowness of the Government’s treatment roll-out programme. They demanded an urgent national meeting to implement an emergency HIV/AIDS plan and the immediate dismissal of the Health Minister. Protests took place around the country and at South African embassies around the world. Since then events have taken a positive turn, with the TAC meeting Deputy-President Phumzile Mlambo-Ngcuka. Both parties emerged indicating a commitment to work together on HIV/AIDS. Mthathi believes Mlambo-Ngcuka’s positive statements affirming that HIV/AIDS is a national crisis represent a real breakthrough. Commentators have interpreted Mlambo-Ngcuka’s involvement as a sidelining of Tshabalala-Msimang, something the Health Minister denies. While demands for Tshabalala-Msimang to be sacked remain, Mthathi sees the TAC in negotiating mode. He warns that a lack of progress by World AIDS Day on 1 December will take the TAC ‘back to the streets’.