As HIV/AIDS has become a foremost public health concern, HIV/AIDS programs as a form of development aid offer .entry points to study shifting ideas about eligibility, vulnerability, and risk. Drawing on my combined training in public health and anthropology, I seek to apply a critical perspective to the roles of public health-as-development programs. My research focuses on the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and its decision to restrict funding for "orphans and vulnerable children" to children directly affected by HIV/AIDS. Using ethnographic methods, I will follow policymakers in the U.S. and South Africa, NGO officers, and families claiming entitlements in a community in KwaZulu-Natal to see what becomes of a policy as it travels between Washington and South African communities. My research proceeds from concerns about how a policy decision that defines the ambiguous and contentious category of the "OVC" is articulated, implemented, and co-opted; how the category of "OVC" is constructed; and how it is mapped onto the lives of children and kinship networks. My research is framed around three problematics: technologies of health and development; categories of eligibility based on ideas about orphans, childhood, and kinship; and theoretical trajectories around medicalization and subjectivity. I take the implementation of the PEPFAR policy as a site for examining the politics of the OVC ·category and how it is shaped by negotiations between forms of knowledge, expert discourses, and local, national, and international politics. I am interested in understanding how, in addition to restricting services, the use of the category re-organizes ideas about vulnerability, family, and childhood. I will also attend to the ways that an ambiguous and changing category is employed by individuals in defining themselves, in coping with illness and loss, and in negotiating access to services.