In this chapter, we provide a theoretically informed account of why movement coherence around a common “ask” – global treatment access based on lower drug prices – was a necessary albeit insufficient condition contributing to the AIDS treatment campaign's overall or relative success. The chapter elucidates the importance and mechanisms of influence of movement coherence contrasted with other less successful campaigns, namely, those addressing climate change and maternal mortality. We also examine within-case variation in the AIDS advocacy movement, including differences between treatment and prevention, the effects of splintering among national level AIDS advocates in the United States, and changes in unity over time in support for the global treatment agenda.

Using interviews, archival material, and other narratives, we provide a historically contingent account of how the movement cohered around global access to treatment. The main contribution of this chapter is thus conceptual, clarifying why movements that lack coherence or unity tend to fail. While a number of other important foundational pieces have told the chronological history of treatment advocacy (Sawyer 2002; Behrman 2004; d'Adesky 2004; ’t Hoen 2009; Geffen 2010), these pieces by their nature are more descriptive than analytical, making it difficult to identify generalizable aspects of the campaign's organization. Even more theoretically inclined accounts (such as Smith and Siplon 2006; Grebe 2008; 2011; Messac 2008; Gartner 2009a) tend to use existing scholarship instrumentally (such as McAdam, McCarthy, and Zald 1996; Zald 1996; Keck and Sikkink 1998) rather than make their own theoretical contributions or systematically test their arguments.