What's the fuss all about? Do the words in the political declaration the UN is negotiating to review its commitment to fight AIDS make any difference? Why do people fight over these specific words: human rights, global targets, treatment, women and girls, vulnerable populations, harm reduction? It is hard to imagine that people will ever know the words that are so passionately parsed, carefully nuanced and artfully arranged to hide political agendas.

Will a teenage girl in Niger know these words as she is sold by her family into marriage as one of four wives allowed by custom in some Islamic customs, (or a "fifth wife" that becomes a servant to the other four)? What about the woman that injects drugs in the Ukraine where life has been anything but easy and risky behavior rampant as a result? Does the man in Syria or the Baptist minister in Alabama who hides his sexual attraction to other men know that some people believe he "deserves" to get AIDS? Is the risk of stigma greater to him than the risk of disease? Is he putting women at risk too? What about the sex worker in Brazil, (where sex work is legal) will she or he consult the declaration? Will a young African boy whose sexuality is expressed differently than those of his friends in his village find any comfort in this political declaration?

It is hard to imagine most of the governmental officials around the world will know these words. So what's the fuss about? It is about accountability – holding leadership just as responsible for their actions (or lack of) as they ask (or demand) of the people they represent. People at risk may never know about government officials, advocates and public health experts at the UN fighting on their behalf.

After 25 years, the disease is more prevalent than denial, but denial runs deep in many ancient customs, religious traditions, political and diplomatic posturing – deep enough to dillute the words, and thus accountability, governments and those who value tradition over public health will one day face for their failure to act now.

Now the truth is far more uncomfortable because everything we knew about the potential for disaster in the early years, when denial prevented Presidents and Popes from even uttering the word AIDS publicly, is fact. The only question that remains is, if we can't find a cure for AIDS, is there one for denial? One would think 25 million deaths and 40 million infections would have done that already.