A common assumption is that international health policies are imposed on developing countries, owing to their high level of dependence on international aid. In reality, the process is likely to be complex. Drawing on analytical frameworks developed to study policy transfer between jurisdictions, this paper explores how far two globally promoted infectious disease policies (DOTS for tuberculosis and syndromic management for sexually transmitted infections) were voluntarily or coercively transferred in one particular setting, Mozambique. The paper suggests that guidelines emanating from these policies were not imposed, but evolved in the 1980s through technical networks of national and international experts. Further, that it was experience at the country level that fed into the globally promoted policies of the 1990s. By the time the policies were transferred by WHO and other international organisations to developing countries in the 1990s, Mozambique had already adopted their guidelines for good practice.