The governments across the world have endorsed numerous international Conventions and Declarations (C&Ds) that enhance interventions to reduce the impact of HIV and AIDS. The objective of this study was to assess the extent to which the governments of Lesotho, Malawi and Mozambique have implemented HIV and AIDS international and regional C&Ds to which they are signatories. Data were collected through literature reviews, face to face interviews with Key Informants and FGDs. Ministries of Foreign Affairs, justice and parliaments were consulted to establish the C&Ds to which each of the three countries had signed. The establishment of various co-ordinating bodies and notably the NACs has facilitated the delivery of a more effective response. The development of HIV and AIDS policies, the production of national HIV and AIDS frameworks and accompanying instruments by the NACs, all demonstrate the impact of compliance with the C&Ds. There is an unrecognised inability by governments to disseminate information about its obligations and a tendency by technocrats in governments to unwittingly keep such information in a technically crude form. The C&Ds have barely been made public and this has implications for focus, direction and accountability. Important advances regarding policy development and legislation have been made, but most of the instruments available are poorly implemented due to weak capacity. The C&Ds must be disseminated beyond technocrats and programme managers to the wider public. National action frameworks and strategic frameworks should be more directly and explicitly linked to the C&Ds to ensure a concerted effort in the pursuit of goals articulated in C&Ds. M&E systems should incorporate and reflect at least the main indicators from each C&D. National HIV and AIDS policies should have policy statements that support the same. C&Ds should clearly articulate processes, mechanisms and structures that governments need to put in place to achieve the objectives of particular C&Ds. (Contains 1 table.)