{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:01:27Z","timestamp":1785423687247,"version":"3.56.0"},"reference-count":64,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010203","name":"Walter Reed Army Institute of Research","doi-asserted-by":"crossref","award":["HT9425-24-3-0004"],"award-info":[{"award-number":["HT9425-24-3-0004"]}],"id":[{"id":"10.13039\/100010203","id-type":"DOI","asserted-by":"crossref"}]},{"award":["HT9425-24-3-0004"],"award-info":[{"award-number":["HT9425-24-3-0004"]}],"id":[{"id":"https:\/\/ror.org\/0145znz58","id-type":"ROR","asserted-by":"publisher"}]},{"name":"U.S. National Institute of Allergy and Infectious Diseases, NIH"},{"id":[{"id":"https:\/\/ror.org\/043z4tv69","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019273","name":"National Institute for Medical Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100019273","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/05fjs7w98","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>The era of highly effective pre-exposure prophylaxis (PrEP) has transformed HIV prevention, yet global HIV incidence remains unacceptably high, particularly in sub-Saharan Africa. While antiretroviral-based prevention is critical, persistent structural barriers to access and adherence highlight the urgent need for a complementary preventive HIV vaccine. In this narrative review and perspective, we argue that scientific progress toward an HIV vaccine must be matched by equally ambitious preparedness investments across three domains: manufacturing and supply chains, clinical trial and regulatory infrastructure, and delivery systems and community engagement. Drawing on lessons from the global rollout of PrEP, post-exposure prophylaxis (PEP), and the COVID-19 pandemic response, we outline a five-pillar strategic roadmap. This roadmap focuses on ensuring that a future HIV vaccine reaches the people who need it most from the moment of regulatory authorization, calling for co-investment in diverse platforms, binding advance market commitments, logistical simulation, and proactive planning for post-licensure effectiveness trials. Preparedness is not secondary to science; it is its essential partner.<\/jats:p>","DOI":"10.3390\/vaccines14070627","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:54:13Z","timestamp":1784534053000},"page":"627","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond PrEP: The Imperative for an HIV Vaccine to End the Epidemic in Africa"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5131-3136","authenticated-orcid":false,"given":"Nicaise","family":"Ndembi","sequence":"first","affiliation":[{"name":"International Vaccine Institute, Africa Regional Office, Nyarugenge, 1 KN 78 St, Kigali P.O. Box 3413, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9008-7730","authenticated-orcid":false,"given":"Morenike O.","family":"Folayan","sequence":"additional","affiliation":[{"name":"Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos 100001, Nigeria"},{"name":"Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife 22005, Nigeria"},{"name":"Department of Public Health Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Pilorget","sequence":"additional","affiliation":[{"name":"International Vaccine Institute, Africa Regional Office, Nyarugenge, 1 KN 78 St, Kigali P.O. Box 3413, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1575-4521","authenticated-orcid":false,"given":"Nyanda E.","family":"Ntinginya","sequence":"additional","affiliation":[{"name":"Mbeya Medical Research Centre, National Institute for Medical Research, Mbeya P.O. Box 2410, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0463-8998","authenticated-orcid":false,"given":"Betty","family":"Mwesigwa","sequence":"additional","affiliation":[{"name":"Makerere University Walter Reed Program, Kampala P.O. Box 16524, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-265X","authenticated-orcid":false,"given":"Trevor A.","family":"Crowell","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3085-5259","authenticated-orcid":false,"given":"Nyaradzo M.","family":"Mgodi","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Centre, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0461-6438","authenticated-orcid":false,"given":"Jerome H.","family":"Kim","sequence":"additional","affiliation":[{"name":"International Vaccine Institute, Seoul 08826, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Rosas Cancio-Su\u00e1rez, M., D\u00edaz-\u00c1lvarez, J., Ron, R., Mart\u00ednez-Sanz, J., Serrano-Villar, S., Moreno, S., and S\u00e1nchez-Conde, M. (2023). From innovation to implementation: The evolution of HIV pre-exposure prophylaxis and future implications. Pathogens, 12.","DOI":"10.20944\/preprints202305.1284.v1"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"UNAIDS (2024). The Urgency of Now: AIDS at a Crossroads. 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