Policy slippage is a concept used to describe policy implementation uncertainty or discontinuity resulting mainly from unstable public spending decisions. The cause of this varies in magnitude and frequency. Politics comes in here as it touches resource distribution and determines what is seen on the ground whether in the economic, political or social spheres. Looking at the demand and supply sides with regard to the way decisions are made towards HIV/AIDS and their implementation, it has been observed that there is some convergence in causes and effects. Tanzania was already in dire economic condition when the epidemic was confirmed. Decision in the form of policy was made and in it the supply side ‘promised’ political goods to address the demand sides’ needs. However, there was, and still there is a lot to be desired and a catalogue of hold-ups has been assembled. These include the usual financial constraints that face developing countries where there is a mismatch between capacity and needs. Others include issues of inclusion and/or exclusion of key participants; the effects of the unfinished decentralization; some cultural practices and beliefs have had their toll on the policy; lack of (resource) accountability; the patrimonial state in which informal structures ‘negatively’ affect decision making; and factors external to the country itself. Others include the lacking support infrastructure. The demand side has its pitfalls as well when it comes to slippages. Tanzania has to address these challenges to reduce the levels of slippages and thereby have a more effective system of addressing HIV/AIDS and other epidemics.