This Dossier is set up for the KIT Portal Governance & HIV and AIDS. It introduces the mechanisms of interaction through which HIV and AIDS policies and strategies are developed, implemented, monitored and evaluated at different levels involving both public and private parties.
According to the UNDP's Regional Project on Local Governance, Governance has been defined as the rules of the political system to solve conflicts between actors and to adopt decisions. It has also been used to describe the "proper functioning of institutions and their acceptance by the public". ( And it has been used to invoke the efficacy of government and the achievement of consensus by democratic means.) The terms participation, legality and legitimacy are important in this context. Within this realm —and within this Dossier— HIV and AIDS policies and strategies are addressed.
Note: Following the UNAIDS’ Terminology Guidelines (2007), we use the terminology “HIV and AIDS”, instead of "HIV/AIDS".
This Dossier aims to provide a collection of resources for use in applying democracy and governance approaches to HIV and AIDS work. It is produced to assist efforts to scale up responses to the pandemic and increase access to prevention and care services through collaboration at individual, community and national levels.
The Dossier is organised around key democracy and governance concepts that have direct application to specific needs in HIV and AIDS programming.
The following issues are emphasized:
• Democratic principles and practices
• Rule of law
• Increasing citizens' participation
• Increasing capacity
• Enhanced flow of information
Human rights abuses fuel the spread of HIV and HIV fuels human rights violations. Consequently, HIV and AIDS continue to have devastating impact on the political, social, economic fabrics of developing countries.
Experience shows that HIV and AIDS have an impact on the various dimensions of governance (e.g.: accountability, political stability, rule of law). Conversely, evidence indicates that improving various dimensions of governance (e.g.: rights-based approaches, multi-sectoral responses, participation) can strengthen HIV responses and result in low and stable HIV prevalence. Factors, that contribute to building HIV resilience in states, communities and citizens include: rule of law, empowerment, rights-based education and advocacy; transparency about information and resources, and responsiveness to needs of constituencies, especially the needs of vulnerable and most at risk populations.
Political commitments to achieving universal access to HIV prevention, treatment, care and support offer key opportunities for building HIV-resilient states, communities and citizens. To date, increased resources for HIV and AIDS responses at the global level have have yet to result in: (1) strengthening capacities of states and its citizens and (2) reductions in stigma, discrimination and marginalization.
Within this context, strengthening the various dimensions of governance and the way HIV and AIDS policies and strategies are developed, implemented, monitored and evaluated at different levels involving both public and private parties becomes crucial.
Responding to the HIV and AIDS epidemic and ensuring universal access to HIV prevention, treatment, care and support by 2010 calls for coordinated action across all sectors and for a strengthened local response. Government ministries, such as ministries of finance, health, planning and agriculture for example, all have an important role to play, both at central and local levels. The importance of civil society in service delivery, upscaling responses and influencing policy is also increasingly recognized.
KIT works within a multi-sectoral context and with a variety of partners to strengthen HIV responses. KIT focuses on:
- Policy and strategy development, including analysis of drivers and scenario building
- Costing of programmes and cost effectiveness
- Human resource development, in particular impact assessments, forecasting and long-term planning
- Governance and accountability
- Monitoring and evaluation, including at global and regional levels
- Performance-based management
- Assistance to National Action Committees in documenting lessons learned and evaluation of different models
- Sector-specific mainstreaming approaches
Projects
The KIT Library Query (at the bottom of the page) offers quick access to resources (articles, books) of the KIT Library on Governance & HIV and AIDS.
New and additional resources can be found in the Governance & HIV and AIDS portal.
Differences in antiretroviral scale up in three South African provinces: the role of implementation management.
Schneider, H.; Coetzee, D.; Van Rensburg, D. et al. / BMC Health Services Research (2010).
South Africa’s antiretroviral programme is governed by defined national plans, establishing treatment targets and providing funding through ring-fenced conditional grants. However, in terms of the country’s quasifederal constitution, provincial governments bear the main responsibility for provision of health care, and have a certain amount of autonomy and therefore choice in the way their HIV/AIDS programmes are implemented. This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up.
Tackling Africa's chronic disease burden: from the local to the global.
De-Graft Aikins, A.; Unwin, N.; Agyemang, C. et al. / Globalization and Health (2010).
There is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second gap concerns understanding the processes and political economies of policy making in sub Saharan Africa. The economic impact of chronic diseases for families, health systems and governments and the relationships between national policy making and international economic and political pressures have a huge impact on the risk of chronic diseases and the ability of countries to respond to them.
The Chinese government’s response to drug use and HIV/AIDS: A review of policies and programs.
Li, J.; Ha, T.; Zhang, C.; et al. / Harm Reduction Journal (2010).
This study reviews the current policies on drug use and assesses the harm reduction interventions among drug users in China. Although there remain barriers to the effective implementation of policies on drug use and harm reduction programs, Chinese government has shown their commitment to support the expansion of harm reduction interventions for drug users throughout the country.
The impact of HIV/AIDS on human development in African countries.
Boutayeb, A. / BMC Public Health (2009).
In the present paper, we consider the impact of HIV/AIDS on human development in African countries, showing that, beyond health issues, this disease should and must be seen as a global development concern, affecting all components of human development. Consequently, the necessity of multidisciplinary approaches that model, estimate and predict the real impact of HIV/AIDS on human development of African countries in order to optimise the strategies proposed by national countries, international institutions and their partners is stressed.
15 april 2011
For upcoming events please visit the Portal Governance & HIV and AIDS15 april 2011
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