HIV/AIDS poses a development challenge of unprecedented urgency, especially in Africa. Apart from the terrible personal costs, the pandemic is the single biggest threat to the attainment of the Millennium Development Goals. Over one-third of HIV/AIDS sufferers live in countries classified as heavily indebted. Repayments to creditors by these countries are diverting resources needed to break the links between ill-health and poverty. Radical reform of the Enhanced Heavily Indebted Poor Countries (HIPC) Initiative is vital to mobilise the resources needed to protect current and future generations from the threat posed by HIV/AIDS.