For three decades post-apartheid, the HIV/AIDS epidemic from first acknowledgement to its management as a chronic disease, demanded unparalleled attention. This was nowhere more evident than in South Africa. This book explores how the state responded to its responsibilities to defend and protect (human) security. Linking this to the role of the state as sovereign protector and provider of security, it applies the findings to the broader re-interpretation of sovereign responsibility in the 21st Century. This book does not seek to absolve the South African state of its responsibility to respond. Moreover, it argues that although the state, the government, before, during, and after the transition to democracy, was aware of and acknowledged the threat - political, economic and social - posed by the epidemic, it nonetheless chose not to make the epidemic a priority policy issue. As a result, it argues that the South African HIV/AIDS case illustrates the tension inherent between a state’s ultimate sovereign responsibility to respond and its tactical dependence on external contributors to meet the demands of all of its constituents.