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 disproportionately 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 as increasing scarcity of capital will increase the demand for labour in agricultural production or shift agricultural systems to less labour- and capital-intensive crops. The paper suggests that the most effective means for agricultural policy to respond to HIV/AIDS will entail focusing on: (1) investing in agricultural research to generate improved technologies capable of raising the productivity of crop and livestock systems; (2) rehabilitating agricultural extension services; (3) instituting crop and input marketing systems that contribute to small scale farmers productivity and food security. Finally, the paper provides elements of a framework for governments and donors to assess and potentially modify existing agricultural programmes, policies, and investment strategies for achieving their agricultural and rural development objectives after factoring in the impacts of HIV/AIDS on the rural socio-economy.