New technologies, such as HIV preventive vaccines and microbicides, offer hope for sustained control of the HIV epidemic, particularly in the world’s most vulnerable and marginalized populations. 

Given the obstacles many women encounter when trying to negotiate the use of male condoms, there is an urgent need for more prevention options they can initiate themselves. Despite recent disappointments, efforts are still under way to develop microbicides, and they still remain the best promise of a prevention tool women can control. A large number of scientists in pharmaceutical and biotechnology companies, academic laboratories and government institutions, are also engaged in the search for a vaccine against HIV. However, developing a vaccine presents enormous challenges and a breakthrough is not expected imminently. 

Policy makers and donors need to generate sufficient support for research and development in ways that promote efficiency and coordination and are based on ethical principles, as well as contributions of intellectual and financial capital by the private sector. Developing countries, in collaboration with those who can provide support where it is required, need to build capacity for clinical trials, social research, licensing and access. 

It is crucial to ensure that men and women will have access to new prevention technologies once they have been tested and proven safe and effective. To assure such access and prepare for the introduction of such technologies, issues related to financing, intellectual property right, manufacturing, procurement, logistics, delivery and provider and consumer education must be addressed. Once available, new prevention technologies will be additional prevention methods within comprehensive HIV prevention programming, but will not replace other effective means of reducing the risk of HIV infection.

Ensuring availability of safe and effective vaccines and microbicides will also demand appropriate regulatory approval and licensing infrastructure, manufacturing capacity and reasonably reliable in-country delivery networks. Even when these are in place, ensuring adoption will require end-user awareness about preventive products, effective pricing and financing mechanisms to ensure affordability, and a supportive social and policy environment.