This chapter compares HIV/AIDS policies in Brazil and South Africa over the thirty-year history of the epidemic, focusing on the period between the mid-1980s and the early 2000s. The discussion lays emphasis on the largely divergent policy responses of the two states to the HIV/AIDS pandemic. The chapter begins with an overview of Brazil and South Africa's HIV/AIDS policies, along with critical factors that explain why, despite being two similar societies, they responded so differently to the epidemic. These factors include the nature and the timing of democratic transition and the relatively stronger Brazilian civil society. The chapter argues that Brazil acted far more aggressively than South Africa against the HIV/AIDS epidemic by implementing comprehensive prevention, treatment and care policies. As a result, the Brazilian government has been able to contain the spread of the virus across its population. In contrast, negligence, denial, delay and fragmentation have considerably exacerbated the HIV/AIDS epidemic in South Africa.