There is global momentum to fast track HIV prevention when evidence from countries that have reached treatment targets demonstrates that the world will not end AIDS without stemming new HIV infections. Eastern and Southern Africa has made good progress in addressing the HIV epidemic, however the rate of decline in new HIV infections is not sufficient to reach the targets to end AIDS as a public health threat by 2030.

In 2016, the UN political declaration on ending AIDS by 2020 was precedented by a the establishment of a Global Coalition on HIV prevention with set targets and commitments. The achievement of these targets for primary prevention will be largely dependent on a combination prevention approach that appreciates the structural barriers to access services

In recognition of this challenge, ARASA initiated the Missing Piece of the Puzzle campaign to highlight the need to focus on structural barriers that could contribute to increased access and demand for biomedical interventions and behaviour change to achieve the desired impact.