International relations theorists and global health politics scholars largely fail to communicate with one another. We argue that drawing on insights from classic and contemporary international theory more explicitly will positively augment the study of global health politics. This paper highlights four major theoretical orientations in the international relations literature (realism, neoliberal institutionalism, constructivism, and feminism) and discusses how an understanding of these perspectives can strengthen our understanding of global health policy.
This exploratory data analysis finds a negative relationship between some types of war and HIV prevalence (i.e. as the former increases in intensity, the latter decreases). The study uses a longer time-frame and broader range of countries than similar studies, with explicit differentiation between sub-Saharan African and other developing countries. The study uses a variety of methods for analyzing time-series-cross-section data. These methods serve as both a robustness check for the results as well as a real-world demonstration of common suggestions for TSCS data.
Background: Information regarding the HIV epidemic is in constant flux. New developments in biomedicine, epidemiology, and policy alternatives occur frequently. For national governments structuring responses, decisions about pursuing particular pathway and alternatives can come as the result of several factors, including, e.g., activist pressure or funding streams from IOs and NGOs. This research focuses on how bureaucracies and institutions acquire and manage new information, using it to evaluate and articulate "policy possibilities" — the process of organizational learning.
Method: I describe a theory of organizational learning appropriate to government organizations managing, directing, or contracting disease response; this allows for hypotheses about ideas and behaviors that emerge in learning organizations. I then test the hypotheses on a process-tracing case study of the Mexican government response to the country's epidemic. Drawing from policymaker interviews, scientific articles, government documents, and fieldwork observation, I tell the story of how the quasi-independent response agency CONASIDA addressed the several types of epidemics that Mexico faced.
Results: Organizational learning proves not to be unicausal. When officials intentionally engaged in a process of information prospecting and analysis, they generated more policy possibilities, and the greater number of options provided for more flexible response regimes. For example, Mexico experienced a particularly acute crisis in its blood supply. When research turned up evidence that blood donors were becoming infected, Mexican officials devised two alternative policies for remedying the problem, so that when the first was not effective, they could immediately move to the second. Had they accepted international consensus about the danger being primarily to blood recipients, HIV would have continued to spread via donors.
Conclusions: With much international focus on the implementation and monitoring of "best" practices and policies, organizational learning demonstrates that identifying and designing policy possibilities play an equal or more important role in the success and effectiveness of epidemic responses.
The academic discipline of political science has substantially addressed the politics and policy of the HIV/AIDS epidemic over the last two decades, but the epidemic has not become a full-fledged research agenda of its own, instead fitting HIV into. I analyze and group the extant research into four research programs. I suggest some future directions that political science may take, so as to further investigation of the empirical problem of HIV/AIDS, as well as to meet the disciplinary imperative to advance more general theories and explanations of political phenomena. Keywords: HIV/AIDS, political science, global health, international development, governance, security studies
This dissertation explores the role that organizational learning processes play in state HIV/AIDS policy development. The puzzle addressed is the large degree of variation in policy output across states that are similar in terms of political or economic character. Although one can tell individual stories about each country, the overall variation defies the cross-applicability of many typical explanations.
Where states better draw lessons from experience we should expect two results. First, structural characteristics of the state or of the set of HIV policy responders affects the character and degree of learning: the configuration of decision-making authority and information analytics interacts with the learning process, affecting the lessons drawn and policies pursued. Second, over time we observe some degree of policy convergence among states due to comparison and adaptation from others.
The dissertation employs a mixed-methods approach. As a plausibility probe, econometric analysis tests for such patterns. The research employs an original dataset of 72 countries over 6 years and approximately 25 variables. To address data missingness, multiple imputation techniques were used. There were statisti- cally and substantively significant relationships and patterns, indicating further exploration of the underlying processes.
The work then tests the theory via process-tracing case studies of Mexican and Botswanan HIV/AIDS policy development over the last two decades. Drawing on written accounts, periodical articles, government documents, and oral interviews, the research examines how the availability, management, and application of information affected the policies pursued. In Mexico, two factors have helped to drive success: first, the set of organizations working on HIV/AIDS policy are organized as a loose network with the specialized government HIV agency serving as the hub of decisions and information exchange; second, a stable (but open) set of people have participated over the whole period. Botswana’s success has been more mixed; although its very high adult prevalence levels contribute, organiza- tional learning factors also play a role. Botswanan HIV policy response actors are arranged anarchically and there have been multiple centers of authority. This has detracted from the ability to prospect and identify relevant information and then draw actionable conclusions.
Paxton, Nathan A. 2000. “Outside Public View: Let the Games Begin!” Making Government Work: California Cases in Policy, Politics, and Public Management, 77-93. University of California, Berkeley: Institute of Governmental Studies Press.