Sitting in her doctor’s office in at the Chiradzulu clinic in the south of ern Malawi, one of Africa's poorest nations, a young woman called Modesta has only one complaint: having to chew swallow 16 pills a day. It seems a minor concern for someone who As an with HIV victim who was close to death four years ago from Aids, the complications caused by the virus, but now looks healthy and expresses hope for the future.

A In theory, a pledge by the leaders of the G8 Group of Eight leading industrial countries at Gleneagles earlier this last month to achieve “as close as possible to universal access to [HIV] treatment for all who need it by 2010” offers fresh optimism to her and millions of other sufferers in the developing world who until recently had little hope of survival. In practice, as AIDS specialists gather in Brazil later this month and. Yet Her story shows how considerable difficulties remain. the challenges in meeting such an ambitious goal. Few politicians, companies or doctors have yet grasped the enormity of the task. “AIDS is a huge problem,” “There is no real strategic approach, no real global leadership, and the policymakers are avoiding every thorny issue,” says Ellen ’t Hoen, head of Médecins sans Frontières’ campaign for access to essential medicines.