Because of the extraordinary progress in the fight against HIV/AIDS, we can now consider a question that just a few years ago seemed far-fetched. No longer is it whether we can achieve an AIDS-free generation. Now, the question is: How long will it take and will it be sustained? Vaccines historically have played an important role in the control and even elimination of global health scourges such as smallpox, polio and measles. So two important questions regarding an AIDS-free generation are: Is an HIV vaccine needed to reach this goal, and if so, what role will it play?

An AIDS-free generation would mean that virtually no child is born with HIV; that, as those children grow up, their risk of becoming infected is far lower than it is today; and that those who become infected can access treatment to help prevent them from developing AIDS and from passing the virus on to others. While the road to an AIDS-free generation will be long and arduous, recent progress in HIV/AIDS prevention and treatment has been encouraging.

Initiatives such as the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria are channeling antiretroviral treatment to millions of people in hard-hit countries. Of the estimated 34 million people worldwide infected with HIV, more than 10 million have access to antiretroviral drugs. Treatment reduces the levels of virus in infected individuals, benefiting their health and lessening the chances that they will transmit the virus to others.