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This report looks at what is being done to challenge the pace of progress on access to antiretroviral medicines in three very different African countries - Botswana, South Africa and Uganda. It describes who is driving these initiatives at grass-roots level and how. It offers insights and draws on lessons from firsthand experiences that can help those already working towards better access to antiretrovirals, and encourages others to embark on similar initiatives. It is intended for all those with an interest in this issue, from policy- and decision-makers with the power to create a favourable environment for antiretroviral treatment, to those working on the front line in health services, NGOs and AIDS service organizations, as well as those living with HIV, whose role in the battle for wider access is vital