Politics behind Aids policies: Case studies from India, Russia and South Africa

In the fight against the AIDS pandemic and its numerous sub-epidemics, the prevention of new of HIV infections, i.e. primary prevention, will play the most important role in the foreseeable future. Based on by theoretical models from the fields of social psychology, sexology and social learning, a consensus on methods has developed over the last fifteen years which can effect and reinforce the necessary behavioural changes in the areas of sexuality and iv drug use. Such interventions follow the approach of the WHO's Ottawa Charter on Health Promotion of health (1986). They have proven successful all over the world, among different cultures, classes and target populations. The overcoming of political, cultural, economic and organizational obstacles to this approach (politics) presents greater difficulties than the designing of appropriate measures, incentives and infrastructures for primary HIV infection (policies). The present publication brings together case studies of AIDS politics in India, Russia and the Republic of South Africa. In South Africa, the implementation of a previously formulated policy is being hampered, above all by the simultaneous dissolution of the Apartheid regime and the resultant changes in the institutional framework. In India, the most important impediments - now that the AIDS epidemic is no longer simply being denied - are taboos on discussing sexuality and the extensive oppression of women. Finally, in Russia, an politically extraordinarily heterogeneous coalition is currently hindering the establishment of the basic preconditions for AIDS prevention, such as the introduction of sex education. In addition to analyzing the obstacles, all three case studies also suggest means of overcoming the current deficiencies as well as areas where further research is needed. The contributions published here were first presented in Geneva at the 12th World AIDS Conference, Bridging the Gap, Grand Round Session, Politics behind AIDS Policies (D 15) on June 29, 1998.