Medical professionals practising double standards in research ethics, health-care safety and scientific rigour have allowed HIV epidemics to develop into national disasters in more than a dozen countries in sub-Saharan Africa. Researchers have followed HIV-positive Africans who did not know they were infected to study HIV-related morbidity, mortality and transmission to unsuspecting spouses and children. Public health managers do not warn Africans about risks to contract HIV from unsafe health care, and no African government has investigated any unexplained and suspected nosocomial HIV infection by tracing and testing people who attended suspected clinics. Researchers have avoided finding and talking about nosocomial HIV infections in countries with generalized epidemics. Rejecting double standards in health-care safety and scientific rigour may be essential to solve and stop Africa's HIV epidemic. Allowing competitive international trade in generic drugs to treat AIDS could mitigate some of the harm done by these double standards.