The chapter traces the development of the international response to the pandemic of HIV/AIDS from the designation of the World Health Organization (WHO) as “lead agency” in the late 1980s to the emergence of a variety of public-private partnerships from the 1990s onwards. This trajectory is related to general trends in global public health governance. Existing partnerships in the field of HIV/AIDS are described and typified. Finally, the legitimacy and democratic qualities of today’s global governance arrangements in the fight against AIDS are discussed in terms of coordination, representation and accountability.