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 or probably) 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' pre-existing 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.