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Drawing on a twenty-year study, we examine the effects of HIV-related illness and death on villagers in Malawi during 2006. Contrary to unidimensional images of an AIDS disaster, we found people striving for normality - trying to control the abnormal circumstances of the rising toll of HIV-related illness and death. Just over 40% of the sample households had experienced at least one death (certainly to likely) related to HIV, but only about 10% were found to be suffering acute or serious livelihood stress due to HIV deaths. The ability to deal with illness and death depended on households’ preexisting characteristics, particularly income level and, critically, on their placement in the extended matrilineal family. But increasing pressures on an already severely stressed population, and failure of the current ‘community-based’ approach to deliver needed help argue for more concerted efforts to link the HIV epidemic to broader based development.