21 Icons South Africa, the series that celebrates iconic South Africans who have inspired people around the world because of their exceptional achievements, on Sunday, 1 December the episode will be screened on SABC3 at 18:57 with Achmat.

As filmmaker and photographer Adrian Steirn says about Achmat’s extraordinary record of HIV/Aids activism: “It wasn’t a fight that anyone wanted to champion. It was a fight that nobody wanted to know about. It’s no coincidence that Zackie Achmat is the man who stood up and said ‘I’m alive with HIV’. He was born to be an activist.”

Indeed, activism started early for Achmat when he partook in the 1976 uprising against Bantu education and, then in 1977, set alight school buildings at the age of 15. This introduced him to the apartheid government’s jails — places with which he would become quite familiar in years to come, including in solitary confinement.

“We had unqualified teachers, we had a serious lack of textbooks, broken schools, bad infrastructure, corporal punishment, really horrible principals with no qualifications and a terrible attitude towards kids,” he explains to the 21 Icons team.

But, he says, his capacity to always take a stand against injustice probably stems from his sexual orientation. “I think it came with the fact that I was gay and having to take a stand on that with my parents, who were religious, and them not understanding. Having to take that stand made it much easier to take any other stand,” says the man who told his parents he was gay when he was just 10-years-old.

Achmat was diagnosed with HIV in 1990 and believed he would die shortly thereafter. “In 1990 people — even doctors — believed that you had six months left to live from the point of diagnosis,” he says.

“It was very difficult. I spent six months in bed watching all the videos I ever wanted to see and reading all the books that I wanted to read. And then one day I woke up and thought I've put on weight. And I'm still here.”

Achmat shared his status openly. “I told my friends and comrades. I didn't hide it,” he says. And, crucially: “I never had unsafe sex since then.”

By 1996, antiretroviral drugs became available and people who took them in other parts of the world stopped dying. Here in South Africa, however, their prohibitive cost meant they were out of reach of the people who needed them most: the poor, who carried the majority of the HIV burden.

It was then that Achmat realised that HIV had become a human rights issue and took up the fight against exploitative drug companies and discriminatory health policies.

He also took the fight to a personal level. “At that time I was also starting to get sick. I was sick all the time, and I realised that I could afford antiretrovirals because my friends would buy it for me. But I knew that if my sister or brother had HIV, the same wouldn't apply. And because we had to struggle for medicine, I decided not to take antiretrovirals as a protest against drug companies, because I believed that they should be available to everyone,” he says.

Not even Nelson Mandela, who visited Achmat at home in 2002 in an effort to persuade him to take his medicine, could change his mind. “I think Madiba understood when I spoke to him that it was an issue of principle,” he says.

“I thought I would die, but I also knew that hundreds of South Africans were dying. At least 600 South Africans a day were dying because of HIV and because the government was neglecting the issue.”

Achmat continued his refusal until 2003, when a national congress of TAC activists voted to urge him to start taking antiretroviral drugs. But it was a visit by Mandela to an HIV clinic on the Cape Flats that finally changed his mind.

“He put on this HIV T-shirt when he visited Khayelitsha Site C clinic. It was a few days before the ANC national conference in 2003 in Stellenbosch. That moment I realised that I could take my pills because what he had done then was to take a stand against a party that he had given his life to,” Achmat says, in reference to the Aids denialism that had prevented a progressive stand and action on HIV treatment.

Shortly after he started taking his medicine, the government announced that it would make it available in the public sector. Another victory was that global pharmaceutical companies agreed to provide access to generic HIV/Aids medicines that would save – and continue to save – millions of lives each day.

Even though his record speaks of tremendous conviction and courage, Achmat denies that he is brave. “No, stubborn,” he says. “Stupid sometimes, and motivated by fear for what can go wrong.”

These days, Achmat continues to fight for social justice issues such as proper sanitation in South Africa’s poorest townships. Perhaps due to his own school experiences, he is also active in Equal Education, a movement working for quality and equality in South African education. “Nothing angers me like injustice, but I don't stay angry because you can't struggle and win if you're angry,” he says.

Steirn’s portrait of Achmat, which will be published in the Sunday Times on Sunday, 1 December, shows the campaigner surrounded by the words “Alive with HIV”. It will be auctioned at the end of the series and the proceeds donated to his selected charity the Social Justice Coalition.

For more information visit www.21icons.com. Alternatively follow 21 Icons on Twitter or Facebook.

21 Icons South Africa is sponsored by Mercedes-Benz South Africa, Nikon and Deloitte and supported by the department of Arts and Culture as a nation-building initiative.