An unprecedented surge in donor support for HIV/AIDS treatment over the last decade has lengthened and improved the lives of millions of people living with HIV/AIDS. But because the rate of new infections outpaces the rate of AIDS-related deaths, the number of people living with AIDSand therefore the number of people needing treatmentis growing faster than the funding needed to treat them. In 2009, about 1.8 million people died from AIDS-related illnesses while about 2.6 million were newly infected with HIV, increasing the total number of people living with HIV/AIDS by more than three-quarters of a million. To stem the tide, health policymakers and practitioners need to organize their efforts around a single goal: achieving an AIDS transition. Only by sustaining recent reductions in mortality and bringing down the number of new infections will the total number of people with HIV finally decline. This focus would change assistance policy and practice at every level, for donor agencies, recipient governments, and health practitioners. The way forward includes using effective policies and incentives from the national to individual levels to reduce the rates of HIV infection, as well as taking advantage of the success of treatment programs to further the aims of prevention.