Voluntas: International Journal of Voluntary and Nonproﬁt Organizations Vol. 15, No. 3, September 2004 ( C  2004) Who Can Help People With HIV/AIDS in Africa? Governance of HIV/AIDS and Civil Society Hakan Seckinelgin 1,2 This paper locates NGOs dealing with HIV/AIDS problems in sub-Saharan Africa into the larger governance context within which they function. This aims at a theo- retical shift to assess the aspirational characteristics for the agency of NGOs that are used to legitimate contracting out implementation of internationally designed HIV/AIDS policies to these organizations. The paper interrogates the nature and impact of the governance structure on NGOs and then looks at the implications of this for HIV/AIDS. The questioning is based on a juxtaposition of the perspective of international policy fora in relation to civil society organizations with the way NGO work is perceived by the people at the receiving end of the policies. The paper suggests that as part of the international governance structure, NGOs are limited within the policy frameworks created by this structure. Furthermore, due to their organizational characteristics, NGOs lack capacity to establish sustainable long-term interventions relevant for sociocultural change as perceived by people themselves. KEY WORDS: Africa; HIV/AIDS; civil society; nongovernmental organizations; governance. INTRODUCTION The HIV/AIDS epidemic is one of the most catastrophic phenomena that has and will continue to impact people’s lives in sub-Saharan Africa. Today, around 29 million people are living with the disease in the region. In 2002, 3.5 million people contracted HIV (UNAIDS, 2002a). The epidemic is generalized largely in eastern and southern Africa, inﬂuencing all aspects of society. Various predictions 1 Department of Social Policy, London School of Economics and Political Science, London, United Kingdom. 2 Correspondence should be directed to Hakan Seckinelgin, Department of Social Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom; e-mail: m.h.seckinelgin@lse.ac.uk 287 0957-8765/04/0900-0287/1 C  2004 International Society for Third-Sector Research and The Johns Hopkins University