While analysts have focused largely on the role of political will to explain a government’s willingness to implement effective AIDS policies, little research has explored the origins of that political will. I argue that, through a consideration of the ideological outlook of government officials, we can develop a more nuanced understanding of political will and the desire to implement certain types of policies. To demonstrate the importance of ideology, I examine two cases of national AIDS policies: Uganda, widely hailed for its pro-active response to the AIDS epidemic, and South Africa, largely vilified for its courting of AIDS dissidents. This research shows the importance of going beyond simple examinations of state capacity to reflect the underlying belief structures that make possible (or impossible) certain policy actions.