Highly Active Antiretroviral Therapy (HAART) has dramatically declined morbidity and mortality due to AIDS in the developed world. However, rational use depends on multiple factors such as affordability and accessibility to drugs, a laboratory infrastructure to monitor therapy, trained physicians, and psychosocial support to promote adherence and existence of treatment guidelines. For this reason, translation of these benefits to patients in the poor world has been limited. On the contrary in India, the stage has been set for future development of multi-drug resistant HIV.