Implementing AIDS policy in post-apartheid South Africa.
In common with the rest of the Southern African sub-continent. South Africa is currently experiencing a serious HIV epidemic. When it came into power in 1994, the new, Mandela-led government immediately mobilised funds and adopted a far-reaching AIDS Plan for the country. However, the implementation of AIDS policy in the first four years after 1994 has been characterised by a lack of progress and a breakdown of trust and co-operation, both within government and between government and NGOs. This paper outlines the political context which shaped the development of the AIDS Policy, then examines the difficulties of implementing a comprehensive response to AIDS in a country undergoing restructuring at every level. It questions the notion of "inadequate political will" as an explanation for lack of progress. Involvement by politicians has, in fact, been experienced as a double-edged sword in South Africa, with inappropriate, "quick-fix" actions creating conflict and hampering a more longer-term, effective response. The paper also highlights the importance of groupings outside of government in promoting effective policy actions, and the types of leadership required to mobilise a broad range of actors around a common vision. It concludes by emphasising the need to develop approaches to policy implementation rooted in the possibilities and constraints of the local situation, rather than relying on universal blue-prints developed out of context.
Schneider
H
H
Centre for Health Policy, University of Witwatersrand, Johannesburg, South Africa. helens@iafrica.com
Stein
J
J
D003140:Communicable Disease Control / Q000458:organization & administration*; D003220:Conflict, Psychological; D003299:Cooperative Behavior; D006077:Government Agencies; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006284:Health Plan Implementation; D006291:Health Policy; D006801:Humans; D007373:Interinstitutional Relations; D007857:Leadership; D009939:Organizations, Nonprofit; D011057:Politics; D013019:South Africa / Q000453:epidemiology