Five months ago I wrote about Zackie Achmat. The good news is that he's still alive. The bad news is that about 100,000 other South Africans have died unnecessarily in the meantime.

Zackie is slowly dying of AIDS, but he refuses to take the drugs that would keep him alive, until South Africa's government makes them freely available to the poor. He has become a hero and a symbol in the struggle of AIDS patients and their advocates for recognition and for public medical care, but with the continuing resistance of the administration of President Thabo Mbeki to their appeals, the issue has become more complicated.

It is clear, but seldom spoken, that he is burdened with doubts about his pledge. In interviews his closest friends said that at times they sensed that he wished he could take it back. They said that no one, especially Mr. Achmat, ever dreamed that the government would withhold ARV's as AIDS treatment for so long. What is worse, they said, is that if Mr. Achmat dies now, there is the real chance that his death would not help his cause.

Mr. Achmat acknowledged the same, fidgeting as if uncomfortable in his own reasoning. "The government won't care one bit if I die," he said. "I don't think it will make a bit of difference in their policy."