In a recent report entitled “The cost of HIV prevention and treatment interventions in South Africa” the Centre for Social Science Research of the University of Cape Town calculates the bill for such a package. By 2015 the most expensive year in the calculation a universally accessible public package of health-sector interventions for HIV prevention treatment of opportunistic infections and antiretroviral therapy would cost 20·3 billion Rand about 1.74% of GNP. This level of spending would require a 50% increase in the public purse for health relative to the GNP from 3.7% to 5.4%. Antiretroviral therapy for adults and children would account for 99% of this additional cost. Universal public provision of voluntary counselling and HIV testing control of sexually transmitted diseases and prevention of mother-to-child transmission are surprisingly inexpensive and could be achieved without a perceptible increase in health-care spending. (authors)