While the implications of the AIDS crisis are devastating, some countries in Africa have made progress fighting the pandemic. This report examines how governance in Uganda and Senegal may have contributed to progress in fighting HIV/AIDS. It is suggested that the role of central government has been crucial to successes achieved thus far in the fight against HIV/AIDS. A distinction is made between the development of a multisectoral approach to the epidemic as a key to success, and the template of multisectoral organisation that has been promoted by UNAIDS, the Global Fund and the World Bank, which the author argues is extremely problematic. The author suggests that the successful move away from purely biomedical approaches to disease that has been so important in the international HIV/AIDS campaign, risks going too far toward the opposite extreme, losing sight of the crucial role that the medical profession and the health sector must play. I present a typology of the main activities that governments need to engage in to confront the epidemic, demonstrating that most involve both 'bio-medical/technical' and 'social, economic and political' dimensions. Hopefully, this report can also serve to educate governance experts about HIV/AIDS connecting the physiological and epidemiological features of the crisis with the political and social concerns of those who work in the governance field.
Putzel, J. Institutionalising a Medical Response: HIV/AIDS and Governance in Uganda and Senegal, Special Report, 2003, London, UK; Crisis States Research Centre, 68 pp.