Third: In Alexandra Township in South Africa, an i

Stephen Lewis, the UN's Special Envoy for HIV/AIDS in Africa. Photo by Nicole Toutounji, UNICEF

Third: In Alexandra Township in South Africa, an impoverished township in Johannesburg, I met last month with a wonderful group of women known as the "Go-Go Grannies". There were eighteen grandmothers, all of whom had lost one or more of their children to AIDS, and all of whom were now bringing up one or more grandchildren. That's the stark perversity of AIDS which turns the rhythm of life on its head: grandparents bury their children, and sometimes their grandchildren, before they themselves are buried. We must have talked, under the trees, outside a friendly little community health clinic for nearly two hours. The grandmothers spun their sad, sad, desolate stories, one by one, interspersed with the moments of fun and hilarity and mock teasing that this sort of group networking can provide to ease the pain. But sometimes the pain can never be assuaged. Not even for a moment. The last grandmother to speak, with great reluctance and fighting for control, was a 73-year-old woman, who explained, in strangled whispers, that she had lost all five of her children to AIDS between the years 2001 and 2003.

She was left to care for four orphan grandchildren, and emotionally, let alone physically, she can't cope, because she's falling apart. And I learned, as I left the compound, that all four of the children - all four - are HIV Positive. So within a mere blink of time, she will bury her entire family, two generations, all of whose lives were prematurely savaged by a plague that knows no bounds.

At some point in the future, historians are going to look back at this period and ask, quite simply, how in God's name the world allowed this to happen? Over twenty million people have already perished, the vast majority in the developing world. It's of the same genre as General Romeo Dallaire's question: how did the world stand by and watch the genocide in Rwanda without lifting a finger? There seem to be these historical moments, these historical periods when moral resolve either freezes or evaporates. It's not just unconscionable; it's inexplicable.

The excruciating truth is that the pandemic need not have come to this. If the African leadership, early on, had not been consumed by denial and fear, if the industrial nations, early on, had made resources available,
if the world had been energized around the pandemic as it has been energized around Afghanistan, Iraq and terrorism - the unequal distribution of war and compassion drives me crazy - then millions of people would still be alive today, and millions of others would have a fighting chance of prolonging life, and you wouldn't have between eleven and fourteen million orphans, no different in any way from your children
and mine, from your grandchildren and mine, wandering the landscape of Africa, bewildered, forlorn, anguished, abandoned, exploited, hungry, despairing . cared for by grandmothers or older siblings or communities already reeling and further impoverished by the impact of AIDS. It's a real shock to the system to encounter these orphan kids. Early last month, improbably enough, I accompanied Oprah Winfrey on a tour of orphan settings in and around Lusaka, Zambia. Oprah wants to extend her unrivalled, powerful voice to the cause of African children orphaned by AIDS, and I could see, as we travelled from one orphan environment to another, that even Oprah Winfrey, with her cosmic sophistication, was shaken to the core by what we saw. These are children who are losing, or have lost, their childhood.

In many of the countries of east, central and southern Africa, the clock is ticking backwards. The development gains of the last decades are in reverse; the major millennium development goals which the United Nations
set for 2015 will never be reached. Life expectancy in many countries has dropped from an average age of 60 to 62, down to age 37 to 40. Can you imagine it: losing over 20 years of longevity in roughly a decade? Infant mortality rates are up; children are leaving school to care for sick and dying parents; whole sectors of society - agriculture, health, education, the private sector are diminished and compromised by the loss of the most productive age groups. It is an astonishing tribute to the people of Africa - their resilience and their determination - that countries continue to function, heroically, even as they are assaulted by the pandemic.

When you're on the ground in Africa, watching the pandemic unfold, it's hard not to be gloomy, to be despairing. People are so lovely; death is so pervasive. The needless loss of so many lives, especially the young women in their late teens, and twenties and thirties, victims of a brutal gender inequality. It's all so heartbreaking. And yet it would be wrong of me not to acknowledge the glimmers of hope as we enter 2004.

Finally, resources are inching upwards from many sources; finally, we're going to have a concerted programme of treatment, led by a rejuvenated World Health Organization, determined to put three million people into
treatment by 2005 (3 by 5 is the catch-phrase). It's indescribably exciting, finally we've moved the price of anti-retroviral drugs, generic drugs, down to a level of roughly $150 per person per year, so that African governments, with the help of external resources, can begin prolonging human life; finally, the superb examples of successful prevention initiatives, in Uganda and Senegal, have captured the imagination of the continent; finally, the issue of orphans is being addressed, even if not yet solved; finally, finally, there is a growing,
irreversible recognition that the pandemic has a woman's face, and that if women and girls are not empowered, above all in the control of their own sexuality, the pandemic will never be broken; finally, there is a new energy within the international community, almost palpable, which suggests that this year may see a breakthrough.

But there's something else I want to say that I've never addressed in a speech before, and for which omission, I am deeply self-conscious. I feel frankly ashamed that I haven't yet embraced the full logic of certain arguments. I think inevitably one gets so caught up in the emergency of the here and now, that perspective is dimmed.