Ricardo Pereira is Scientific Officer in the Department for International Relations, Foundation for Science and Technology, Portugal, where he co-manages research funding projects. He is currently a national delegate at the European and Developing Countries Clinical Trials Partnership (EDCTP).

• 1. Introduction: Agency in Global Health 2. Global Health Governance and Role of States 3. Recipient States in an Asymmetric System 4. International Developments of States in Africa 5. PEPFAR: Project of Global Transformation 6. Botswana: National Survival against HIVAIDS 7. Ethiopia: Self-Help with External Support 8. South Africa: Changing HIV/AIDS Policies 9. Conclusion: Recipient States Being Sovereign