In a field of study and practice as diverse and dynamic as HIV/AIDS care and impact mitigation, it is imperative to continuously reappraise both the evolving situation and the assumptions underlying current actions. The priority remains the implementing of effective and scaled-up responses to the pandemic. To keep asking the right questions, researchers and practitioners must understand the range of operational possibilities. The impetus for reappraisal comes from many sources: situation and needs analyses on the ground, empirical field and clinical research, changes in nongovernmental organization (NGO) and government priorities, scenario planning, and the availability of resources that can be directed toward further research.

Most crucially, political pressure is now increasingly being exerted on governments to fulfill obligations outlined in the United Nations (2001) Declaration of Commitment on HIV/AIDS, an outcome of the United Nations General Assembly Special Session on AIDS (UNGASS). Rather than research for its own sake, studies must be linked to the development of operational assistance to guide and scale up action. At the same time, inaction due to lack of knowledge is itself not acceptable. Governments and other key stakeholders must “act on data which is already available…. It is not necessary to wait for data before starting work” (Loudon 2003).

The immediate information needs are overwhelmingly practical and geared toward practitioners and policymakers. More difficult to ascertain, but still vitally important, are the theoretical bases for both the research and the reconsideration of research directions.