Learning to Live?: Examining Differential International Responses to HIV/AIDS


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.
Last updated on 09/25/2010