Antiretroviral therapy (ART) makes a dramatic difference to the survival and health of people living with HIV. At present there are over 5 million people infected with HIV in South Africa. Greater access to ART could change the lives of millions of people. In the light of cabinet's announcement to make highly active antiretroviral therapy (HAART) widely available in South Africa and the mandate to develop an implementation plan, some thought should be given to the principles and strategies that should underlie the implementation of such a programme