Describing the massive conference as overwhelming, Mlambo-Ngcuka says she is proud of the contribution of the significant contribution of South African delegates.

‘€œOne thing I would ask for is that this conference is a wake-up call for all of us on the issue of prevention. We have identified this as a problem, but we have not moved fast enough to address this,’€ says Mlambo-Ngcuka.

‘€œWe need to take extraordinary measures to drive this campaign. If we do well with prevention, then we lessen the treatment and care burden. But the current rate of new infections makes meeting our targets impossible unless we address prevention.’€

Mlambo-Ngcuka looks exhausted as she leans back in a chair on the 43rd floor of her plush Mexico City hotel.

She has been attending both the conference and having talks with the Mexican government to strengthen bilateral relations.

When asked what prevention methods government should adopt, Mlambo-Ngcuka says she favours mass media campaigns, as the country needs a variety of people sending the same message.

Government could be more frank and direct about the dangers of multiple and concurrent sexual partners, one of the key drivers of the epidemic in the southern African region, she admits.

However, she is unsure about whether male circumcision should be promoted as an AIDS prevention measure.

‘€œI fear that men who have been circumcised might think that they don’€™t need to use a condom. So I don’€™t think we can embrace this unless we can be sure we will avoid unintended consequences.’€

Unlike in the past, at this AIDS conference the South African delegation has not been dogged by controversy over its promotion of garlic and beetroot rather than antiretroviral drugs.

This is largely because Health Minister Manto Tshabalala-Msimang did not attend, choosing instead to attend a bilateral meeting with Namibia.

The most senior health officials attending the conference are Dr Nomonde Xundu, head of the HIV/AIDS directorate and Thami Skenjana, who heads the HIV/AIDS communication initiative, Khomanani.

Meanwhile, a study of countries’€™ AIDS leadership by the University of Cape Towns Professor Nicoli Nattrass concludes that South Africa has the worst leadership in the world.

After taking into account a range of economic, demographic and institutional factors including per capita income, HIV/AIDS burden and political stability, Nattrass concluded that South Africa was underperforming by some 36 percent.

A weary Mlambo-Ngcuka sighs: ‘€œWe do not claim to be on top of everything. The protracted tension between different role players, who have more similarities than differences, stole time from us all. We are trying to make up for it and strengthen ourselves.’€ – health-e news.