This chapter critiques South African President Thabo Mvuyelwa Mbeki's skepticism of HIV science and his move to halt the distribution antiretroviral drugs in South Africa. When Mbeki became the president, almost one in five South African adults was already infected with HIV. Rather than immediately developing AIDS policy based on scientific consensus, Mbeki took seriously the claim that HIV science was fundamentally flawed and corrupted by the pharmaceutical industry. He convened the Presidential AIDS Advisory Panel with half the seats allocated to HIV critics, and half to HIV scientists and clinicians. The conflict between the opposing parties delayed the distribution of antiretroviral drugs. The chapter argues that Mbeki's skepticism mirrors three key characteristics of AIDS denialism: extreme cynicism toward the science of HIV pathogenesis; ignorance of advances in antiretroviral treatment; and the active promotion of alternative, unproven therapies in its place.