Debt,adjustment and the politics of effective response to HIV/AIDS in Africa

Today in much of Africa economic growth has slowed and living standards for the majority have suffered in the face of rising unemployment and mass poverty, resulting in incomes that are presently below the 1970 level. One problem that has been the focus of much attention and contention over the past 20 years is the huge foreign debt owed by African countries to bilateral donors and multilateral institutions. Debt servicing is consuming a disproportionate amount of scarce resources at the expense of the provision of basic services to the poor. In order to receive help in servicing their debts, countries must agree to implement structural economic reforms. This often entails drastic cuts in social expenditures, the privatisation of basic services, and the liberalisation of domestic trade consistent with WTO rules. These policy decisions have had a direct impact on the capacity of African countries to promote, fulfill and protect the right to health of their citizens. This is further compounded by ill-conceived privatisation of basic services such as water and health services, without any regard for the ability of the poor to access these essential services at a cost they can afford. Finally, adherence to WTO trade rules, which often comes as an extension of liberalisation policy, hampers the capacity of African governments to produce or purchase less expensive generic drugs for their citizen without fear of retaliation from the developed countries.     

Health,Need and Politics: The Determinants of Bilateral HIV/AIDS Assistance

Over the last 10 years foreign aid for HIV/AIDS control has grown from ‘millions to billions’. This study investigates donor motivations in the targeting of bilateral HIV/AIDS assistance. Are donors selecting recipients primarily based on level of need or are political and merit-based considerations at play as well? The results of our two-stage statistical analysis of bilateral HIV/AIDS assistance flows over the period 2002–2007 suggests that recipient need is an important determinant of aid flows. We also find limited evidence of dyadic political relationships having an effect on assistance targeting, while the quality of recipient policy environments seems to have a minimal impact on donor allocation decisions.     

The 'nameless fever': The HIV/AIDS pandemic and China's women

HIV/AIDS is fundamentally an issue of human rights. To the right to medical provision must be added rights to the provisions of social justice necessary to the prevention and alleviation of HIV/AIDS. China has become the focus of international concern over HIV/AIDS. Applying the concepts of 'capabilities poverty', 'discursive democracy', gender construction, 'structural violence' and the 'hypermasculine state', the study identifies the threat to China's women from HIV/AIDS; evaluates the factors contributing to this threat with reference to issues of human rights; and assesses the quality of the national and international response to the HIV/AIDS threat. It is argued that there is a growing threat to women from HIV infection in China; that there are gender-specific factors that render women in China especially vulnerable; that the belated epidemiological response is weak and its capability to meet the threat seriously weakened by social patriarchy; and that, ultimately, the HIV/AIDS threat to China's women is an issue that can only be resolved through political reform leading to discursive democracy and social justice.     

The politics of HIV/AIDS in South Africa: government action and public response

A decade ago it seemed likely that African governments would be destabilised by the impact of the HIV/AIDS epidemic. This article tests some of the presumptions in such forecasting with an examination of the South African case. It begins with an assessment of the effects on the public health system of the South African government’s efforts to cope with the illness. Efforts to implement universal treatment of people who are HIV-positive appear to have strengthened government, while the costs have been affordable. The efforts have extended the embrace of the public health system and prompted the engagement of civil society in policy formation and implementation. Survey evidence suggests that the government has gained public approval and that its health service delivery has become more socially accountable. Civil protest to engender political reforms in the treatment of AIDS patients has enhanced the role of constitutional checks on executive authority.     

Awareness and quality of knowledge regarding HIV/AIDS among women in India

This paper examines the determinants of women's knowledge regarding HIV/AIDS using data from a nationally representative survey in India. Although around 45 per cent of sample women had heard about the disease, their knowledge regarding its modes of transmission and prevention is found to be limited. To explore the possibility that there may be a different process that determines awareness as opposed to quality of knowledge regarding HIV/AIDS, a negative binomial hurdle model and a two-stage ordered probit model are estimated. The results show that the effect of several covariates, such as education and mass media, on awareness is different from their effect on quality of knowledge.     

HIV/AIDS and older women in Zambia: Concern for self,worry over daughters,towers of strength

The HIV/AIDS epidemic in Africa has exposed the way in which gender relations can place women in a particularly precarious position in respect of health matters (Ankrah, 1991; Baylies, Bujra et al , 1999; de Bruyn, 1992; Heise & Elias, 1995; Obbo, 1993; Ulin, 1992). As it advances, it is also evident that women do not face the epidemic as a homogeneous group, but as one which is divided by varying levels of vulnerability and varieties of response. This article focuses on generational differences, as well as those defined by marital status and economic security, and identifies older women who have completed their families as positioned not just to perform a caring role but also to serve as advocates for others in articulating the dangers which gendered practices may pose for their daughters and for women in general, both married and unmarried. It will be argued that they may become spokeswomen for their communities and their families and should be seen as powerful actors around AIDS issues.