Understanding State Responses to the HIV/AIDS Crisis in Sub-Saharan Africa

Abstract

This dissertation seeks to understand the factors that influence government responses to HIV/AIDS among sub-Saharan African countries. Specifically, I hypothesize that 1) under certain circumstances, countries with democratic institutions are more likely to fight the epidemic aggressively and 2) there are multiple pathways to strong government action. By examining government performance in 29 sub-Saharan African countries, I find strong support for both hypotheses. A case study of Botswana shows that various aspects of a democratic society, from the competitiveness of the political arena to an active civil society, shape government responses to HIV/AIDS.This research has both theoretical and practical implications. It contributes to the existing knowledge about the effects of democracy on public well-being by highlighting that, even in regions where democratic institutions may not be well-established, their dynamics are still powerful enough to encourage governments to adopt policies that benefit their populations. Additionally, it expands our understanding of HIV/AIDS policy-making in sub-Saharan Africa and in other areas of the world by specifying the different environments which lead governments to be aggressive in addressing the epidemic, a finding of interest to those involved in the field of development.