When I covered my last AIDS conference, in Geneva in 1998, already most of the cases of HIV infection around the world were in Africa and it was clear that AIDS would devastate that continent. Also unanimous, in my perception, was a sense of helplessness about doing anything to stop that ongoing disaster.

That has all changed. This week I covered sessions about provision of antiretroviral therapy (ART) to adults and children in many African countries as well as programs to prevent mother-to-child transmission. One million people are now in treatment in Africa.

These accomplishments “have turned out not to be so difficult,” Joy Phumaphi, assistant director general of WHO, told me. Contrary to Western worries, people in developing countries do adhere to ART. Delivery of anti-HIV drugs is facilitated by integrating it into existing programs to treat TB and antenatal care programs. Next comes introduction of ART into primary care programs. Financial obstacles were overcome by formation of the Global Fund to coordinate donations, by the U.S. PEPFAR program and by Medicin sans Frontiers, Phumaphi said. Drug donations from pharmaceutical companies have also played a major role.

Despite these advances, in sub-Saharan Africa, the epicenter of the HIV pandemic, only 23% of persons who need treatment are getting it. Calls echoed throughout the halls this week to build on the hope that early success has generated and finish the job.