The Pacific regions response to the AIDS epidemic is as uneven as its economic growth and poverty reduction. Limited awareness and understanding of the potential impact of the epidemic, weak health care systems and an unsupportive legal environment have all contributed to varying degrees of response by Governments across the region. The Report of the Commission on AIDS in the Pacific has clearly highlighted the factors inhibiting a strong and determined response to the epidemic. While some of these are known, it is for the first time that all the issues were addressed so comprehensively by the Commission.