Relatively few people have access to antiretroviral treatment in South Africa. The government justifies this on grounds of affordability.Nicoli Nattrass argues that the government's view insulates AIDS policy from social discussion and efforts to fund large-scale intervention. Nattrass addresses South Africa's contentious AIDS policy from both an economic and ethical perspective, presenting: • a history of AIDS policy in South Africa • an expert analysis of the macroeconomic impact of AIDS • a delineation of the relationship between AIDS and poverty and the challenges it poses for development, inequality and social solidarity • an investigation into how a programme preventing mother-to-child transmission would be less expensive than having to treat children with AIDS-related illnesses • an exploration of the relationship between AIDS treatment and risky sexual behaviour • an economic and social case for expanded AIDS prevention and treatment intervention. This relevant and accessible work is a valuable resource for readers with an interest in AIDS policy and the social and economic implications of the pandemic.