This image of a woman carrying bricks on her head to help build an AIDS research laboratory has remained with me over the past few months, as a symbol of how India is still building the foundation it needs to combat the HIV epidemic. Whether constructing state-of-the-art research laboratories brick by brick or spreading HIV prevention messages one village at a time, India has to muster all of its limited resources. And, like the woman rushing back for another load of bricks, India must hurry to catch up with the fastest growing HIV epidemic in the world.

To help India lay its foundation, the Harvard AIDS Institute joined with several Indian organizations last May to sponsor an AIDS conference in Pune, a city south of Bombay and at the center of the epidemic. Leading experts from around the world gathered to discuss India's challenges in confronting HIV. As each spoke, frightening pictures emerged--of a population still perilously ignorant of the epidemic, of centuries-old traditions facilitating transmission of a new virus, of infected people being denied lifesaving medical treatment.

Just a few miles away from our conference site, in Pune's red light district, more than half the sex workers are already infected with HIV. But the virus is not just affecting those with high-risk behaviors. Last year, in Pune, the National AIDS Research Institute found that 14 percent of married women who reported no history of sexual contact outside their marriages had tested positive for HIV.

This premier issue of the Harvard AIDS Review focuses on India's struggle with the epidemic, for our editorial aim is to track the paths of the virus and the paths of research around the world. In addition to our special report, we include an article that outlines the urgent need for an AIDS vaccine specific to developing countries. Another story highlights the Internet--one of the few forces capable of matching the speed and worldwide spread of HIV--and its potential to enhance the work of the AIDS community. We also feature Harvard's new center for biostatistical AIDS research, which holds promise for accelerated analysis of clinical trials.

We hope the Harvard AIDS Review will help counter the tide of complacency toward HIV. Vasantrao Gowarikar, the vice chancellor of Pune University, spoke at our conference about how easy--and dangerous--it is to dismiss the epidemic. He likened the imperceptible spread of HIV to the subtle shifting of the Indian subcontinent. "The Indian land mass is drifting at about two centimeters per year," he said. "We cannot see it, so we do not lose sleep over it. Yet there is movement everyday."

Much more rapidly than land shifts, HIV is inexorably changing our world. We must act with haste and determination toward resolving this worldwide crisis. For if we dismiss the virus, our inattention will eventually be reckoned in vast numbers of lives lost.