ABSTRACT
This chapter argues that the South African Government assumed not only responsibility but also accountability in its response to the HIV/AIDS epidemic. Most significant is PEPFAR's financial contribution to the fight against the HIV/AIDS epidemic: it is by far the largest donor program in the world. Consequently, PEPFAR most profoundly illustrates the long-term human security costs of unresolved delineation of responsibility without corresponding accountability. At the same time though in the background, the South African Department of Health established 199 public health facilities capable of providing HIV/AIDS related services by the end of 2005, including antiretroviral treatment. The dependence that accepting the Global Fund grant implied pried open the portals of South Africa's jealously guarded domestic sovereignty. State sovereignty still has a critical role to play in providing, protecting and preserving human security. Evidencing this, in August 2001, the South African Government refused to make the antiretroviral Nevirapine available to pregnant women to stem the tide of mother-to-child-transmission (MTCT).
