A prominent South African Aids activist has told the BBC former President Thabo Mbeki should be called to account for his decision to block HIV medication.
A recent Harvard School of Public Health study said 330,000 deaths were caused by his 1999 decision to declare available drugs toxic and dangerous.
Zackie Achmat said Mr Mbeki had ignored the scientific evidence.
Mr Mbeki's spokesman referred media enquiries to the government, but no spokesman was available to comment.
Mr Achmat, who leads the Treatment Action Campaign, which successfully lobbied for the eventual reversal of government policy, claimed Mr Mbeki had "blood on his hands".
He called for him to be summoned to a judicial inquiry or the Truth and Reconciliation Commission.
The study, published on 20 October, said that as a result of Mr Mbeki's policies, nearly 35,000 babies were also born HIV-positive between 2000 and 2005.
The former president had failed to roll out the drugs which could have prevented mother-to-child transmission, said the researchers.
The study, led by Dr Pride Chigwedere, accused the South African government of "acting as a major obstacle in the provision of medication to patients with Aids".
The authors said that under the leadership of Mr Mbeki, the government had restricted use of donated anti-retroviral drugs and blocked funds for more than a year from the Global Fund to Fight Aids, Tuberculosis and Malaria.
To estimate the benefits they say were lost to South Africans because of the failure to provide appropriate drugs between 2000 and 2005, the researchers looked at a number of factors.
• the number of patients who died without receiving treatment
• the relative cost of the drugs and the resources available
• comparative treatment programmes in Namibia and Botswana.
Since the former president was replaced in September 2008 a new health minister, Barbara Hogan, has been appointed and she has been praised by Aids campaigners for tackling the HIV issue with determination.