The HIV/AIDS pandemic will transform Africa as we know it. Taking a pessimistic view of current trends, this article foresees the emergence of AIDS-related national crises (ARNCs). Just as HIV infection itself kills through other infections, the pandemic-induced crises will manifest themselves in a range of other social, economic and political pathologies, with potentially severe implications for food security. Most current models of the AIDS pandemic assume that governance of affected countries will remain unchanged or even improve in the face of these crises. However, these approaches have left out a potentially crucial element of negative feedback. In light of these special features of ARNCs, normal responses to these crises will not work, and may in some respects make the situation worse. The priorities of development partnerships will need to be re-evaluated, and concerted efforts must be taken toward prevention. The article concludes that African nations, and their international partners, may need a new model of governance over the next few decades that reflects the far-reaching impacts of ARNCs.