After 25 years, there is a broad though sometimes superficial awareness of state responses to HIV/AIDS in the global South, where the spread of disease is said to be fueled by inept or failed states, those so poor or whose officials are so indifferent that they lack public health services or even a minimal health care infrastructure. But this narrative ignores the failed responses among states struck in the first wave of the pandemic in the early 1980s. In the long run, generally between 1986 and 1990, the industrialized democracies where a new illness was first identified did implement comprehensive disease prevention, blood safety, and treatment and care regimes specifically targeting AIDS; in the short run, these same countries struggled over—and more often then not failed to implement—appropriate measures to stem the spread of the epidemic. And in the long run, tens of thousands contracted HIV and died.Michael J. Bosia, Assistant Professor at Saint Michael's College in Vermont, has been an activist and policymaker ([email protected]). He thanks the Fulbright fellowship program, a Blaine J. Yarrington Fellowship from Northwestern University, and Saint Michael's College for financial support.