Multisectoral Coordination of HIV/AIDS

This Ph d dissertation studies the multisectoral coordination of HIV/AIDS programmes in the period 2000-2010. Until 2000, HIV/AIDS was mainly regarded as a health issue. Multisectoral coordination implies that sectors outside the health sector will be involved in HIV/AIDS work in addition to non-state actors, such as civil society organisations and the private sector. It is important to study such coordination because African countries have adopted it as the strategy and structure for coordination of HIV/AIDS programmes in these countries. To ensure multisectoral coordination, starting around 2000, most countries with large-scale epidemics (e.g. African countries) began to establish formal national and local government coordination structures. The national coordination structures included the National AIDS Commission/Council (NAC) and a country coordinating mechanism (CCM), and the local coordination structures were a local government HIV/AIDS committee and a local government HIV/AIDS coordinator. The dissertation studies how these formal government structures attempt to coordinate among themselves and with the three main global HIV/AIDS programmes- the President’s Emergency Programme for AIDS Relief (PEPFAR), The Global Fund to Fight AIDS, Tuberculosis and Malaria and the World Bank Multisectoral AIDS programme (MAP) at the global, national and local levels. This coordination is discussed in the four journal articles and an introductory chapter. The first article is an analysis of global-level coordination pattern and challenges among the global HIV/AIDS programmes and among them and African governments. The second article is Article 2 reveals the pattern and challenges to national-level coordination in Tanzania within the government (internal) and between the government and global programmes and other actors (external), along the vertical and horizontal dimensions. The article then discusses how the pattern and challenges unveiled and the influence of the global programmes in this coordination can be explained by the political economy of the policy sector in which such coordination takes place. The third article provides a study of the patterns and challenges to multilevel coordination between national and local levels and local-level coordination in Tanzania. The local-level coordination is examined through a case study of Ilala municipality. The article assesses how transparent and accountable the national and local-level coordination structures are in coordinating across levels. In addition, the article assesses how representative and participatory the local government coordination committee is in its work. Furthermore, the article discusses how the global programmes contribute to and influence the national–local and local-level government coordination in Tanzania. The fourth article uses the findings from the three preceding articles and other scholarly literature to discuss and explain how challenges in the multisectoral coordination of HIV/AIDS programmes are part of the general aid coordination challenges in Tanzania. List of articles. Articles 2-4 are removed from the thesis due to copyright restrictions. Article 1: Hellevik SB 2009: ‘Making the Money Work’: Challenges towards Coordination of HIV/AIDS Programmes in Africa. In: MacLean S, Brown S and P. Fourie (eds) Health for Some: The Political Economy of Global Health Governance. Houndmills: Palgrave Macmillan, 145-164. Reproduced with permission of Palgrave Macmillan Article 2: Hellevik SB: The Pattern and Challenges to Multisectoral HIV/AIDS Coordination in Tanzania. To be published in the International Review of Administrative Sciences Vol 78 (3 ) September 2012. Article 3: Hellevik SB: Coordination of HIV/AIDS Services through Multilevel Governance in Tanzania? Submitted to Public Administration and Development. Article 4: Hellevik SB: Multisectoral HIV/AIDS Coordination in the Context of Aid Coordination. A Study of Tanzania. Submitted to Development Policy Review