On a Sunday afternoon in June of 1999, I got a phone call about a meeting being held that night to plan a "party." As a veteran of numerous AIDS protests with ACT UP/NY, I knew that meant an action was taking shape, but I had no idea that this meeting and the subsequent actions would reshape the nature of my activism and would play an important part in changing the way the U.S. responded to the global AIDS crisis.

Prior to that night, I had never worked on global AIDS issues. First, we had plenty of problems right here at home (and still do): overly expensive drugs that led some states to restrict access; a continuing epidemic among my fellow gay men; a president who talked a good line about "feeling our pain" but did little to stop it (he barred the use of federal funds for needle exchange programs); and to top it all off, a real burn-out problem among AIDS activists.

And second, the problem of AIDS around the world was just too big for a simple activist to grapple with. When you looked at the enormity and complexity of the problem, where could an activist start? There was only one thing many of us were "sure" of: we could never get HIV drugs to the countries that needed them the most. They were just too expensive: over $10,000 a year. Well, that's how much they charged here in the U.S. -- we could never find out how much they actually cost to make, since that information was fiercely guarded by the drug companies. But we thought (wrongly) they must cost many hundreds of dollars a year, far out of the reach of countries that spend only a few dollars a year on health care per person.

So I was surprised to find that the action being planned was about getting HIV treatment to Africa. Activists had gotten hold of a leaked State Department document detailing how the U.S. was working to prevent cheaper HIV drugs from being used in South Africa. Here was the deal: in 1997, South Africa had passed the Medicines and Related Substances Control Act, authorizing "compulsory licensing" and "parallel importing" to make or import far cheaper versions of HIV drugs. But the drug companies were not happy -- they wanted South Africa to continue to buy drugs directly from them, not import them from other countries or make cheaper generic versions. Of course, virtually no one in Africa could afford the drugs at full price, and without them, millions would die.

According to Jamie Love from the Consumer Project on Technology, the U.S., under pressure from the drug companies, had put South Africa on its "301 Trade Watch" list, a warning signal that trade sanctions could follow. Ironically, our government was threatening to restore the trade sanctions that had been lifted in 1993 when apartheid had ended! In addition, South Africa had been kicked off the list of countries that had been promised debt cancellation. Clearly, there was serious outside pressure to prevent this nation from doing what was needed to save its own citizens.

But efforts to publicize this problem had met a dead end. AIDS in Africa, compulsory licensing, generic drugs, the 301 Trade Watch list -- who could wrap their head around any of this, much less pitch it to reporters on tight deadlines who knew nothing about the issue? A year of work on the story had led to only one article, in the Chicago Tribune. Beyond that, nothing. The Washington Post had been promising an article for months, but it never seemed to materialize.

So members of ACT UP/NY and F.U.Q. (Fed Up Queers) called a meeting to do a "zap" (a surprise protest) that would finally get the issue into the papers. The target? Al Gore. My first thought was, "Wait a minute -- do I want to do anything to damage the man I desperately want to defeat George Bush?" But then I heard that Gore had been personally involved in talks with South Africa's then Vice President, Thabo Mbeki, as part of "an assiduous, concerted effort" to "repeal the Medicines Act," according to the leaked document. Turned out one of Gore's closest campaign advisors was Anthony Podesta, a top lobbyist for the pharmaceutical industry. So I knew we had the right target. He was concerned about how he looked on the AIDS issue, and I was sure that a zap in June of 1999 would have little effect on an election in November of 2000.

Gore was announcing his candidacy in Carthage, Tennessee, that Wednesday and again the next day in New York City. Of course, a zap in NYC would be a lot easier, but some of us argued that if his first announcement was in Carthage, that's where the cameras would be. So we rented a van and headed to Tennessee, while ACT UP/Philly started working the phones to prep the media.

We had called to see if tickets were needed for the event, and were told they weren't. But when we arrived at 7 a.m., we found out that those without tickets would be about a block away from the stage -- not what people had just driven 16 hours for! I surveyed the ticket-takers, and chose the sweetest-looking grandma there. "Hi! We just drove 16 hours from New York City to cheer Al, but we don't have tickets! Is there any way we can get in?" She took one look at our "Columbia Students for Gore" t-shirts and said, "Well, sure! Y'all come on in!" We walked right up to the front and positioned ourselves directly between Al and the cameras. Gore was not scheduled to speak until 11, so we passed the hours making friends with the Tennessee Democrats all around us -- some of the friendliest people you could hope to meet. We talked about all the things we mutually held dear, all the while feeling guilty about what we were planning to do to their favorite son.

Finally, the event began -- country music, speakers, Gore's daughter, and then the man himself. I had volunteered to blow the first whistle to kick off the action. Al started talking: about women's rights (couldn't disrupt there); about voting rights for blacks (no, not there); about immigrant rights (not yet); and then about "stronger families." Okay, close enough to "family values" for me -- I got up on a fence, ripped off my t-shirt to reveal one that said "GORE'S GREED KILLS" and blew my whistle.

All hell broke loose. We began chanting, "Gore is killing Africans -- AIDS drugs now!" One of the women we had been chatting with for hours turned to us with tears in her eyes: "I can't believe you're a part of this!" Others became violent, chipping one woman's tooth by pulling out her whistle; punching the only other man in our group in the jaw. But mostly they just tried to drown us out, making far more noise than the 12 of us could ever hope to make. The cameras focused on us immediately, and I could see Gore was furious. He attempted a feeble, "I love free speech!" and then forged ahead, actually announcing his candidacy during our protest.

The media reaction was immediate. Suddenly, our issue was news. Why was Al Gore blocking AIDS drugs? Why was the U.S. bullying South Africa? What was parallel importing? The Washington Post ran its promised article the next day, and we kept up the pressure. Seeing the success of our zap, members of ACT UP/Philly raced to New Hampshire that same day and were able to hold a banner reading "AIDS Drugs for Africa" not two feet behind Gore as he spoke. Inspired by their action, we hurried back to NYC and hit him again the next morning on Wall St. When he came onstage, he looked me right in the eye -- I'm sure he recognized me. I smiled as if to say, "Hi, Al, here I am again," and blew my whistle.

We continued to hit Gore fundraisers, and soon our zaps became the story, not his candidacy -- a disaster for his campaign. More importantly, people began writing about the possibility of actually providing generic HIV drugs to people in poor countries.

On September 17, after months of zaps and meeting with officials, the U.S. changed its policy toward South Africa. And in May of 2000, after continued pressure (including taking over the offices of the USTR), Bill Clinton expanded the policy to all nations, issuing an Executive Order that "... the United States will henceforward implement its health care and trade policies in a manner that ensures that people in the poorest countries won't have to go without medicine they so desperately need."

Al Gore would later break with Podesta and come out forcefully against the pharmaceutical industry, and after leaving office Bill Clinton would work to lower the cost of triple-drug HIV therapy to $130 a year. George Bush would renew Clinton's Executive Order and even create a program to deliver generic HIV drugs to people in 15 developing nations. And in 2006, the majority of sessions at the International AIDS Conference would focus on the nuts and bolts of delivering HIV treatment to developing nations -- not whether or not we could do it.

But on that day in Carthage, there were only a handful of us saying what is now universally accepted: generic drugs are the only hope we have to save the lives of millions of people around the world. I don't want to give us too much credit, as many others have fought long and hard on this issue, but when I think of those early zaps I'm reminded of what Margaret Mead once said: "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it's the only thing that ever has."

Mark Milano is a longtime AIDS treatment activist and is Editor of ACRIA Update_._