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The political environment of HIV: lessons from a comparison of Uganda and South Africa

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  • Parkhurst, Justin O
  • Lush, Louisiana

Abstract

Considerable interest has arisen in the role of governance or political commitment in determining the success or failure of HIV/AIDS policies in sub-Saharan Africa. During the 1990s, Uganda and South Africa both faced dramatic HIV/AIDS epidemics and also saw transformations to new political systems. However, their responses to the disease differed in many ways. This paper compares and contrasts the ways in which policy environments, particularly government structures, can impede or expedite implementation of effective HIV prevention. Four elements of these environments are discussed--the role of political leadership, the existing bureaucratic system, the health care infrastructure, and the roles assigned to non-state actors. Two common international strategies for HIV prevention, syndromic management of sexually transmitted infections and sexual behaviour change interventions, are examined in relation to these elements in Uganda and South Africa during the mid-to-late 1990s. During this period, Uganda's political system succeeded in promoting behaviour change interventions, while South Africa was more successful in syndromic management efforts. Interactions between the four elements of the policy environment were found to be conducive to such results. These elements are relatively static features of the socio-political environments, so lessons can be drawn for current HIV/AIDS policy, both in these two countries and for a wider audience addressing the epidemic.

Suggested Citation

  • Parkhurst, Justin O & Lush, Louisiana, 2004. "The political environment of HIV: lessons from a comparison of Uganda and South Africa," Social Science & Medicine, Elsevier, vol. 59(9), pages 1913-1924, November.
  • Handle: RePEc:eee:socmed:v:59:y:2004:i:9:p:1913-1924
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    Citations

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    Cited by:

    1. Marcella M. Alsan & David M. Cutler, 2010. "Why did HIV decline in Uganda?," NBER Working Papers 16171, National Bureau of Economic Research, Inc.
    2. Dawn C. Parker & Kathryn H. Jacobsen & Maction K. Komwa, 2009. "A Qualitative Study of the Impact of HIV/AIDS on Agricultural Households in Southeastern Uganda," IJERPH, MDPI, vol. 6(8), pages 1-26, July.
    3. Bor, Jacob, 2007. "The political economy of AIDS leadership in developing countries: An exploratory analysis," Social Science & Medicine, Elsevier, vol. 64(8), pages 1585-1599, April.
    4. Blair, Robert A. & Curtice, Travis & Dow, David & Grossman, Guy, 2022. "Public trust, policing, and the COVID-19 pandemic: Evidence from an electoral authoritarian regime," Social Science & Medicine, Elsevier, vol. 305(C).
    5. Young Soo Kim, 2015. "Obstacles to the response to HIV/AIDS in South Africa: Historical legacies in perception and policy environment in 1994–2006," International Area Studies Review, Center for International Area Studies, Hankuk University of Foreign Studies, vol. 18(2), pages 199-215, June.
    6. Parkhurst, Justin O. & Chilongozi, David & Hutchinson, Eleanor, 2015. "Doubt, defiance, and identity: Understanding resistance to male circumcision for HIV prevention in Malawi," Social Science & Medicine, Elsevier, vol. 135(C), pages 15-22.
    7. Clarke, George R.G. & Cull, Robert & Fuchs, Michael, 2009. "Bank Privatization in Sub-Saharan Africa: The Case of Uganda Commercial Bank," World Development, Elsevier, vol. 37(9), pages 1506-1521, September.
    8. James O. Olufowote & Johnson S. Aranda & Guoyu E. Wang & Danni Liao, 2017. "Advancing the New Communications Framework for HIV/AIDS: The Communicative Constitution of HIV/AIDS Networks in Tanzania¡¯s HIV/AIDS NGO Sector," Studies in Media and Communication, Redfame publishing, vol. 5(1), pages 79-92, June.
    9. Smith, Stephanie L., 2014. "Political contexts and maternal health policy: Insights from a comparison of south Indian states," Social Science & Medicine, Elsevier, vol. 100(C), pages 46-53.
    10. Lisa Ann Richey, 2012. "Counselling Citizens and Producing Patronage: AIDS Treatment in South African and Ugandan Clinics," Development and Change, International Institute of Social Studies, vol. 43(4), pages 823-845, July.

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