The International AIDS Conference began in Durban with a stinging indictment of South Africa's president Thabo Mbeki and his failure to deal with the AIDS tragedy in his country.

• INDEPTH: AIDS in Africa

The sharp words came from a judge on South Africa's highest court. Justice Edwin Cameron called Mbeki's stand — or lack of it — on AIDS akin to signing a death sentence for millions of people in his country.

Thabo Mbeki

Cameron said with the eyes of the medical world on South Africa this week, Mbeki has the chance to take a stand and announce prevention and treatment programs and ensure the availability of lower priced AIDS drugs. Instead, Cameron accused Mbeki of flirting with dissident scientists who don't believe HIV causes AIDS.

Cameron is a high profile member of the bench on South Africa's highest court. He also has AIDS.

Last year he went public with his condition after a young woman, an AIDS activist, was stoned to death because she was HIV positive.

Edwin Cameron

Cameron has been living with AIDS for 15 years. He says that's because, unlike millions of other Africans, his judge's salary allows him to afford the anti-retroviral drugs that keep his disease in check.

"I stand here before you because I am able to purchase health," he said.

Cameron lays the blame for the disparity at the feet of President Mbeki.

In a stinging condemnation, Cameron accused Mbeki of ignoring the link between HIV and AIDS. He called it "flirtatious and puzzling."

He went so far as to compare Mbeki's actions to that of the government in Nazi Germany and the old South Africa under apartheid.

In time, he said, history may show that Mbeki's denial and inaction caused the death of millions of people.

"In my own country, the government that in its commitment to human rights and democracy has been a shining example to the world, has at almost every conceivable turn mismanaged this epidemic," Cameron said. "So grievous has this ineptitude been that South Africa has since 1998 had the fast growing epidemic in the world."

Cameron says there has been all kinds of talk by Mbeki — but no action.

"In truth there has been a veritable cacophony of government task groups, workshops, committees, councils, draft proposal statements and pledges all signifying piteously little."

Cameron's concerns are shared by the chair of this conference, Hoosen Coovadia, a prominent pediatrician at the University of Natal in Durban. Like Cameron, he's upset that Mbeki held tight to his unorthodox views on AIDS throughout his speech at the opening ceremony.

"I guess what I am sensing now is an absolute disappointment that that was not adequately addressed," said Coovadia.

Coovadia is also a member of the president's council on AIDS. He says he believes Mbeki can't sustain his position for long. He believes this conference will help Mbeki change his mind.

"I think by Friday, when all the scientific evidence is presented, when you put all that together and you throw in the cost-efficiency studies, there is absolutely no escape route ... by Friday that option to not make a decision will not be there."

Cameron urged Mbeki to use this conference as an opportunity to secure lower cost drugs and bring in programs to prevent the transmission of HIV from pregnant women to their children.

He says this week could be a turning point for Mbeki — and not just another opportunity for Mbeki to dabble in medicine and criticize mainstream scientists.