There is a race against time for millions in the world today. Both the technology and the manpower are currently available to deliver the services that are required to meet the needs of the 40 million people currently living with HIV/AIDS, but at what price? The reality is therefore that we are a long shot away from this realization. What are the facts and why have we not achieved even the simplest deadlines set by the World Health Organization (WHO)? Are these objectives realistic? What role does hard science have to play in the search for cost-effective solutions and futuristic effective options? To stem this unrelenting epidemic and convert the natural history of the disorder in those already living with the virus into one of chronicity, rather than one characterized by a dehumanizing and stigmatized death, requires a global commitment at all levels. This discussion examines the reality and offers a snapshot of capacity and experiences in the developing world. Crucially, it looks at the immediate and long term role of flow cytometry in the expanded care and treatment programs for developing nations.