I'm not sure when it will support IA64 or Vista, but Strawberry Perl should work on IA32/x86_64 using Windows 2k, XP, or 2003. It gives you the majority of CPAN modules at your disposal without using Cygwin.
There are some modules that still need massaging or that don't work, but you won't know if the modules you use are supported without checking.
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