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This report surveys the public- and private-sector efforts on HIV vaccine research and development in the past year, with a focus on the US government agencies and pharmaceutical companies that are most likely to make a difference. It finds that, despite an impressive array of dedicated researchers and increasing funding for HIV vaccines, the world will fall short of President Clinton's deadline. US government research efforts are not focused on results, leaders err on the side of caution rather than on moving forward, responsibility is diffuse, and the nation has stood silent as pharmaceutical companies, including the world's largest vaccine producer, make little or no investment in one of the greatest public health challenges of our century. AVAC addresses these obstacles and recommends an agenda for action in this report.