This collection of essays provides a provocative critique of leadership on HIV/AIDS in Africa since the 1980s to the present. It examines the rhetoric on HIV/AIDS which has influenced culture and behaviour, service delivery, policy, the design of national interventions and the varied success of different countries in containing the pandemic. African scholars put into context a host of public and scholarly disputes ranging from from AIDS exceptionalism and Thabo Mbeki's 'denialism', to the racist debates on 'African promiscuity' and the recent revival of assertions that homosexuality is not an 'African' behaviour. The text refers to the record of governments in a wide range of African countries with case studies drawing on the rhetoric of governments and the nature of government leadership in South Africa, The Gambia, Morocco, Zambia and Ethiopia and the African Union's declarations on HIV/AIDS. What emerges is that the rhetoric is diverse, occasionally logical and effective in terms of informing systemic HIV/AIDS interventions that improve the welfare of people, and sometimes it is contradictory to the point of absurdity.