This chapter discusses the history of transnational activism recounted relevant at the time of writing; a time where fiscal austerity, ‘donor fatigue’, and excessive drug pricing remain barriers to universal access to Human Immuno-Deficiency Virus (HIV) prevention and treatment around the world. It discusses the South African movement’s critical contribution of moral legitimacy to the transnational HIV treatment access movement in its early years. The chapter argues that domestically generated components thereof – the Treatment Action Campaign's (TAC) success in popularising and defending the science behind HIV treatment; its effective socio-economic rights litigation and its use of ‘struggle symbolism’ – were critical in bolstering its legitimacy both in South Africa and internationally. It describes the early global achievements of the TAC and its allies: that is, increased funding to fight global Acquired Immunodeficiency Syndrome and for intellectual property arrangements enabling access to cheaper generic medicines.