Writing as the co-founder of the Bill & Melinda Gates Foundation, Bill Gates discussed HIV/AIDS in his annual letter. The Microsoft billionaire-turned-philanthropist stressed the importance of scaling up prevention efforts such as male circumcision, ensuring access to care in developing countries and supporting vaccine research.

“Treatment is important, but we urgently need innovations to prevent the spread of HIV, which is where the foundation has focused a lot of its efforts,” Gates wrote. “Trials are in progress on pills and gels that we hope will substantially reduce the chance of getting infected. We will begin to see the results from these trials late this year.”

Gates also spoke about the well publicized HIV vaccine trial in Thailand (his foundation did not fund that research, but it does strongly support vaccine work). “Although there are several ways of analyzing the data and the vaccine had only modest effects, the results of the trial were good news,” he wrote. “They showed the scientific community that a vaccine is possible.”

In stressing the importance of innovative prevention efforts, Gates recalled being skeptical last year about the prospect of male circumcision to decrease HIV transmission rates. He felt men wouldn’t volunteer for the procedure. Nonetheless, the foundation funded pilot programs to scale up male circumcision in developing countries.

This year, he offered a different viewpoint. He recalled a visit last December with French scientist Bertran Auvert, who was conducting a study in Orange Farm, South Africa, on the effectiveness of circumcision.

“He and his co-leader, Dirk Taljaard, are modest about their work, but amazingly, they are getting over 750 men a month to come to their facility,” Gates wrote. “They have already circumcised 14,000 men, and within a year they think they will be able to circumcise almost all of the men in the community…. Based on this success, a number of facilities are being set up in South Africa and in other countries with high HIV prevalence to do the same thing.”