Objective: In the context of newly evolving political and economic systems and a growing epidemic, this study examined how national level HIV/AIDS strategies in Tanzania, from 1989-1999, were affected by changing organizational priorities among the government, multi- and bi-lateral organizations, and international non-governmental organizations (NGOs). Methods: Data were collected through 21 key informant interviews and review of 33 technical documents. Content and taxonomic analyses were used to explore for themes related to critical incidents influencing agenda setting and organizational barriers and facilitators to HIV/AIDS programs. Results: The National AIDS Control Programme (NACP) has encountered increased barriers, as its mandate has grown more complex and demanding. Explanations include: (a) the government's delay in placing HIV/AIDS as a high priority, consequently fostering an atmosphere of stigma and silence and limiting the NACP's effectiveness; (b) changing and inconsistent donor strategies accompanied by unreliable funding; (c) lack of donor coordination; (d) tendency by donors to apply a generic "African" analysis and solution to Tanzania; (e) inadequate analysis by government or donors of the complex political and economic forces affecting HIV/AIDS program delivery in Tanzania; and (f) the pervasiveness of poverty. Implications for practice: (1) Call for official aid agencies to re-examine their methods of working with host country governments in determining public health priorities - the concept of "shared sovereignty" - and how that relates to local ownership of problems and solutions. (2) Necessity of organizational actors working in HIV/AIDS programs to do broader contextual analysis of the environment beyond a single sector perspective.
Learning Objectives: At the end of this session, participants will be able to: 1. Identify at least five characteristics of government and donor actions that have influenced Tanzania¡¯s national response to the HIV/AIDS epidemic. 2. Define ¡°shared sovereignty¡± and discuss its application and implication for the delivery of international public health goods in the particular case of HIV/AIDS programs in Tanzania.
Keywords: International Health, Public Health Policy
Awards: - Honorable MentionPresenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.