When I set up the Elton John Aids Foundation 14 years ago, Aids was a death sentence. During the 1990s the foundation provided palliative care, information, and emotional and financial support to thousands ... and prayed for a cure. Today, life-saving antiretroviral treatment is affordable and entirely viable in the developing world. I have met wonderful, courageous HIV-positive Africans who are thriving because my foundation, like many other organisations, has grasped the chance to use these medicines in groundbreaking programmes.
Yet about 70% of Africans who need treatment to survive are still not receiving it. Ultimately, it takes the will of the richest governments on earth to close that gap. In June the G8 pledged to do just that - to provide HIV/Aids treatment for all those who need it by 2010. But we are on track to meet barely half that target. Are we saying that by 2010 we will save only half of those dying from Aids? And if so, how will we decide who should be spared?
The G8 decided that one way to get treatment to all those who need it would be to triple the Global Fund to Fight Aids, Tuberculosis and Malaria, so that by 2010 it could provide £3bn-£4bn for programmes delivering medical care. Next week in Berlin, members of the G8 will attend a meeting of the fund to deliver on that promise.
Gordon Brown's leadership and vision on this issue are needed right now. After all, he helped found the fund and played a central role in getting world leaders to commit to universal access to treatment. Were the UK to provide £700m over three years, tripling its annual contribution by 2010, it would challenge the rest of the world to follow suit.
I am not alone. The Stop Aids Campaign, representing more than 80 UK organisations working in the developing world, feels the same, as do three all-party parliamentary groups responding to Aids, TB and malaria. A bold pledge like this would encourage countries such as Canada, France, Germany, Japan and the US to do their part.
I am not a politician. I see this problem through the lens of my foundation's work. For us, it's about who is being accountable and keeping money flowing to benefit people living with HIV/Aids, rather than inventing more structures or processes. We expect no less from the fund. But I know that in many areas the fund has had an impact where other, less innovative mechanisms have failed. More than a million people in Africa, Asia and Latin America have already received antiretroviral medication, and 2.8 million people suffering from TB, the biggest killer of people living with HIV/Aids, have been treated.
In many regions governments are hostile or reluctant to provide services for the most marginalised groups: men who have sex with men, injecting drug users and prisoners. In responding to this need, my foundation is guided by what is effective rather than what is politically expedient. I have met brave activists who face threats and harassment as they help marginalised groups access basic services. Here again the fund is crucial. It has the flexibility to channel funds without toeing a particular political line.
At the UN last July, the prime minister showed integrity and leadership when he said: "We did not make the commitment to the millennium development goals only for us to be remembered as the generation that betrayed promises rather than honoured them and undermined trust that promises can ever be kept."
These decisions directly affect whether people live or die, and I urge the British government to take a lead in ensuring these promises are kept. Honour the pledge.