Throughout the long plane ride back from southern Africa to New York, I was haunted by what I had just seen. Before leaving for the airport, I had visited a hospital pediatric ward, where a dozen babies lay in late stages of AIDS, their large, dulled eyes disproportionate to their thin, weak bodies. I knew that by the time my plane landed in New York, at least two of the babies would most likely have died.

As I walked through the terminal after the plane landed, I bought a copy of the Sunday New York Times, whose magazine cover blazoned, "When AIDS Ends." The cover article discussed the "twilight of an epidemic." The depiction of the peaceful aftermath of the HIV epidemic was alarmingly far removed from the global reality - the pediatric ward I had seen just hours before.

By now we have all heard stories of people’s health miraculously improved by the protease inhibitor combination therapies. But the drug cocktails are not a cure for AIDS. While they have indeed improved the length and quality of life for some, they benefit only a fraction of those infected worldwide. For people in the developing world - an overwhelming 90 percent of all those infected with HIV - the cost of advanced treatments is prohibitive. Of the remaining 10 percent, more than one-third don’t respond to the treatments or can’t tolerate them. Some can’t keep up with the rigorous daily regimen of timed doses and dietary requirements. And the longevity of the drug regimens remains undetermined. Many people may, over time, develop resistance and experience drug failure.

Reports that suggest the crisis is over send the worst possible message for preventing HIV - and for sustaining the worldwide campaign against the epidemic. In the industrialized world, some people whose behaviors place them most at risk believe they no longer need to avoid becoming infected. Surveys of young people consistently find that they don’t perceive themselves to be at risk. Meanwhile, new infections continue unabated, striking with deadly force among youth and communities of color in the United States, and at times obliterating entire families in developing countries. With more than 16,000 people becoming infected with HIV each day, millions worldwide desperately need accelerated prevention efforts.

In this special report on HIV prevention, the Harvard AIDS Review spotlights just a few prevention strategies. We explore the power of commercial media to communicate prevention messages to youth. We examine the evolution of needle exchange programs and efforts to establish federal approval. And we touch on the search for an international vaccine.

To complement this special report, Institute Chair Max Essex describes Princess Diana’s plans - cut short by her untimely death - to draw international attention to the tragedy of perinatal HIV transmission in the developing world, where, for relatively little money, most mother-to-child infections could be prevented. The Princess very much wanted to help us showcase to the world that the babies now dying in the pediatric ward need never have become infected.

While the success that many people have enjoyed on the drug cocktails is cause for celebration, the global reality is that the AIDS crisis is far from over. As those dying babies reminded me, this is not the time to let down our guard against HIV. Only with stepped up prevention efforts and a safe vaccine can we finally rid the world of AIDS.