To develop a research agenda for use of antiretroviral therapy (ART) in countries with highly limited resources for health, research questions focused on 3 areas: when therapy should be initiated, what therapies should be used, and the most appropriate methods for patient monitoring. Participants from 23 countries and 6 continents were clinical and academic researchers, health care practitioners, policy authorities, pharmaceutical experts, and health care advocates. The conference attendees reviewed background materials and participated in 13 state-of-the-art presentations on ART provision in resource-limited countries, treatment access, ethics, community issues, and sustainability. Conferees separated into smaller groups to identify priorities for specific research agendas. Existing multinational human immunodeficiency virus (HIV) clinical trials networks, such as the HIVNAT (The Netherlands, Australia, and Thailand) Network, were studied as infrastructure models for research into affordable, sustainable treatment and monitoring strategies suitable for resource-limited settings. The delivery of ART in resource-limited countries is a vital priority for health care providers and the millions of people living with HIV disease. To achieve sustainable approaches to HIV/acquired immunodeficiency syndrome care, research relevant to resource-limited settings must involve local researchers and community representatives to promote development of local capacity.