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Standing at the 20th anniversary of the President’s Emergency Plan for AIDS Relief (PEPFAR), Vietnam can claim many successes achieved throughout this history. As the first Asian country to receive PEPFAR support and currently the only Asian country with a standalone bilateral COP, Vietnam holds a unique place in PEPFAR’s progress and milestones over the last two decades. This history involves the transformation of HIV from a near-certain death sentence to a more easily prevented and treated condition, bringing hope and options for all populations to remain holistically healthy.