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This paper considers how the design of agricultural policies and programmes might be modified to better achieve policy objectives in the context of severe HIV epidemics and underscores the central role of agricultural policy in mitigating the spread and impacts of the epidemic. Based on projections of future demographic change in the hardest-hit countries of eastern and southern Africa, HIV/AIDS is likely to have the following effects on the agricultural sector: (1) increased rural inequality caused by is proportionately severe effects of AIDS on relatively poor households; (2) a reduction in household assets and wealth, leading to less capital-intensive cropping systems for severely affected communities and households; and (3) problems in transferring knowledge of crop husbandry and marketing to the succeeding generation of African farmers. It is argued that -- even though the absolute number of working age adults in the hardest-hit countries is projected to remain roughly the same over the next two decades -- the cost of labour in agriculture may rise in some areas as increasing scarcity of capital (notably, animal draft power for land preparation and weeding) will increase the demand for labour in agricultural production or shift agricultural systems to less labour- and capital-intensive crops.