Forty million people are living with HIV/AIDS worldwide, 28 million of them in Africa south of the Sahara. When I began photographing this problem in 2002 only about 2% of people with HIV had access to anti-retroviral drugs (ARVs) to treat the illness. In the U.S., in contrast, AIDS medication was widely available. People in sub-Saharan Africa it seems lived in a world of medical apartheid, where the right to health and life were available across geographic lines that remained inaccessible.

Six years later the situation is beginning to change. Largely through the intervention of the Bill and Melinda Gates Foundation, the Clinton Foundation, and the U.S. PEPFAR program, drugs are more widely available. But delivery remains a work in progress and most of the infected still do not have access to ARVs. Since they are mothers and fathers their deaths have left millions of orphaned children -- a problem that will not disappear regardless of access to medication.