A reality check for aspirational targets to end HIV.

www.thelancet.com/hiv Vol 2 January 2015 e11 levels of undiagnosed infections. If aspirational, then such goals may be reasonable; however, it is problematic if health bureaucrats, politicians, and community members believe that achieving 90-90-90 targets by 2020 will necessarily achieve a 90% decline in HIV transmissions by 2030 in the current context in which no HIV cure or effective vaccine exist. As successive years fail to align with ambitious HIV transmission targets, campaigns and programmes that may be successfully reducing transmission could be jeopardised if their measure of success is a substantial decline in new cases of HIV.