In global and Pacific responses to HIV, echoes of earlier experiences of leprosy can be heard. Those working in many capacities with HIV - as health professionals, development practitioners, policy-makers, even historians - have drawn parallels and 'lessons from leprosy'. Within a Pacific context, this article reflects on some of these parallels and 'lessons', and the questions they raise. The latter relate to the care and integration of patients within their communities, human rights, and 'classic' approaches to public health. Although many people involved in the initial response to AIDS in the 1980s and early 1990s looked fervently to history for answers, the didactic role of history is not simple, as this article exemplifies. In conclusion, the question 'Can history teach anything?' prompts some reflections on the dialogue between the present and the past, and a final parallel between leprosy and HIV - one concerning the special potency of historical records that preserve life stories.