This paper reviews the ad hoc evidence and explores the potential of decentralised systems of social protection (DSSP) to contribute to the fight against HIV/AIDS. The paper focuses on systems set up by associations and organisations in civil society to cover workers and households that do not have access to statutory systems of social protection. It places particular attention on the role of health micro-insurance schemes (HMIS), which constitute a dynamic innovation in terms of community mechanisms to face health-related risks. It also enhances the social role of many DSSP, which may be as important, and potentially more important, in the fight against HIV/AIDS.