Until quite recently, bringing antiretroviral therapy to severely resource-constrained countries was not considered to be a priority. It was widely felt that in these settings a preventive HIV vaccine is the only way to win the war. Antiretroviral therapy was perceived to be too expensive and complex, to pose impossible monitoring demands, and to drain valuable resources from more important prevention efforts. However, both from a humanitarian and an economic and developmental perspective, we cannot afford not to bring highly active antiretroviral therapy (HAART) to these settings.