The virus later blamed on Haiti arrives from central Africa

The best reconstruction available puts the arrival of the human immunodeficiency virus in Haiti at about 1966, carried by one infected traveller from central Africa. Nobody knew. It spread quietly for fifteen years, and Haiti became one of the first countries outside Africa with a substantial epidemic. In 1981 the United States Centers for Disease Control listed Haitians as a risk group beside homosexuals, haemophiliacs and heroin users, which is how a whole nationality came to be classified as a disease. The listing was withdrawn in 1985. By then Haitian immigrants in the United States had lost jobs and housing over it, blood banks turned them away, and what remained of Haitian tourism collapsed. In the same year the virus arrived, Graham Greene published The Comedians, a novel set in Duvalier's Port-au-Prince that told readers abroad what the regime was, filmed the following year. Haiti became known to the world through a book about its dictator and a diagnosis.

Every morning at six, as the light reached the Caribbean, a young Haitian journalist named Raymond Alcide Joseph went on the air from a New York station with news of Haiti in Kreyol and sharp jokes at the expense of the president. Haitians called the programme six o'clock mass, and few people with a transistor missed it. Joseph spoke for the Coalition Haitienne, an exile group backed by Paul Magloire that stayed away from invasions, having watched the farce in the Florida Keys in 1966 where a landing party was stopped by federal agents while a television crew paid for the story and helped write the script. The Voice of America had dropped its Kreyol service on instructions from the White House, so for three years Joseph's Radio Vonvon was the only competition for the two hours a day Rene Depestre broadcast from Havana. Duvalier obtained jamming equipment licensed for export by the United States and used it against Vonvon. He left Havana alone.

On 22 May 1964 an American ambassador presented himself in Port-au-Prince for the first time in four years, and Lyndon Johnson told the new Haitian envoy in Washington that he looked forward to close cooperation. The economic pressure Kennedy had applied began to lift. The Inter-American Development Bank found money for waterworks and the United States Navy resumed shore leave. Foreign aid ran above five million dollars a year. Duvalier was separately taking in about ten million a year through accounts that appeared in no budget, fed by the Regie du Tabac, a tobacco monopoly grown to cover cement, flour, sugar, milk, cars, textiles, matches and much else, with the cash moving through a private bank. No government or lender ever challenged those accounts in public. In late 1965 Duvalier opened talks with the Vatican and named his price, which was a Haitian bench of bishops in place of the French one. Paul VI agreed in August 1966, lifted the excommunication and sent a nuncio back.

The Unified Party of Haitian Communists launched an urban guerrilla campaign in 1966 against a state whose chief had declared himself president for life two years earlier. Young men and women of the organisation left their studies in Europe and returned to Haiti in complete secrecy. Duvalier put his whole apparatus of surveillance, repression and terror on to them. An informer working for the regime led the security forces to them, and they were located and killed resisting. Reprisals followed against the parents, friends and populations who had received them, notably at Cazale, a locality north of Port-au-Prince. Two fighters taken alive there, Alix Lamaute and Lamarre Saint-Germain, were beheaded. Their heads were sent to Duvalier in a bucket. Bernard Diederich, who recorded the episode, noted that this kind of work always brought a generous reward, and that delivering such a trophy to the president for life had become something close to a ritual.