This paper examines institutional governance with specific reference to how African universities are addressing the challenge of HIV and AIDS. Using the case of the University of Swaziland (UNISWA), the analysis explores how the university is dealing with the AIDS epidemic with respect to governance issues, focusing on AIDS-related activities and policy issues. The analysis is based on a sample of 432 students from the three campuses of the University of Swaziland and five (5) focus group discussions (FGDs). The study found out that, since the university does not currently have an HIV/AIDS policy, a guiding framework upon which an effective response can be based is lacking. Moreover, the lack of clear definition of the roles of the diverse actors involved in AIDS-related activities hampers effective coordination and thus renders the current response by the university ineffective. For the university to achieve its mandate at a time when institutions of higher learning are threatened by HIV and AIDS, there is need to develop innovative approaches to governance so as to incorporate effective intervention strategies.