Despite the benefits of antiretroviral therapy in treating HIV/AIDS, government responses have varied substantially, from provisions guaranteeing nearly universal access to insufficient provisions providing almost no access. This research seeks to specifically examine primary explanations, such as economic capacity, and emerging explanations, such as the role of electoral accountability and the presence of stigma, and the coordination between the epistemic community and political leadership as potential causes for the variance in the government provision. By controlling for state economic capacity, this research furthers the importance of examining other explanations for state response in light of a public health crisis. While electoral accountability and the role of stigma had marginal impacts, the level of scientific coordination and understanding among the states political leadership had perceptible impacts. This research also tests broader aspects of the political economy such as the role of state capacity and subsequent government crisis response.