The AIDS movement in Africa is a powerful story of people breaking the conspiracy of silence surrounding this epidemic and demanding equity and dignity. We have seen unprecedented progress that must be sustained and enhanced. But we are at a "make or break" point. If we accept the status quo, we will forsake the 9 million people in low- and middle-income countries still waiting for HIV treatment. Our collective failure to meet this challenge will mean more deaths, more orphans and more new infections.