In this Foreign Affairs opinion piece, Mead Over, a senior fellow at the Center for Global Development, says the goal of an “AIDS-free generation” is attainable, “[b]ut not if treatment continues to take precedence over prevention.” He continues, “It is unfortunate that so many have focused on treatment alone because there is a way to end the global scourge of HIV/AIDS: by conditioning the rate of expansion of treatment programs on the reduction of new infections. This much-needed shift would lead to what I call an AIDS transition — the day on which the rate of new infections falls below the rate of AIDS-related deaths so that the number of people living with HIV/AIDS decreases year-on-year.”

Although policies would vary on how to accomplish this AIDS transition, “some principles apply across the board,” Over writes, adding, “Proposals for HIV/AIDS treatment programs should project not only the number of lives a program will extend but also the number of infections it will avert. Likewise, proposals for prevention programs should demonstrate that they are cost-effectively reducing the number of new infections, thereby freeing financial resources for treatment.” He concludes, “An AIDS transition offers a reasonable, achievable, fiscally prudent, and necessary stepping stone toward a future where a world without AIDS will become a reasonable goal — instead of the fantasy it seems to be today” (12/8).