HIV/AIDS is the greatest health crisis the world faces today and poses considerable challenges to global health policy. This study applies a document analysis methodology to track the evolution of the World Health Organization's (WHO) policy response to the global HIV/AIDS crisis from 1986 to 2004, to shed light onto the WHO's policy formation process and the features in the policy environment that influence global health policy in this arena. The analytical framework developed for the study builds on the work by Lomas, Sabatier and Brewer and examines parameters in the policy environment in three clusters: Principles, Values and Vested Interests, Knowledge and Technologies and Intra- and Inter-Organizational Structure/Dynamics. The results of the analysis demonstrate the creative tension the WHO faces in effecting policy change. This analysis is instructive not only for WHO's HIV/AIDS policy formation, but also for policy to address future pandemics.