AIDS Policy Development in Kenya: A Historical Institutionalist Analysis

Issues

In the face of the devastation that has accompanied the spread of HIV/AIDS in Africa, and the relatively few instances of success, reports of decline in AIDS prevalence in Kenya has been a unique success story. This study used historical institutionalism as the process theory for telling Kenya's AIDS policy story through the analysis of sequence of event with a focus on (a) the timing, (b) key institutional actors (states, intergovernmental organizations, civil society organizations, and multi-national corporations) (c) the dominant narrative voices, (d) the frame of reference in interactions among policy actors, and (e) health polity, political economy and policy process as contexts.

Lessons learned

A combination of internal and external events led to change in Kenya. Key internal events that shaped policy were declaration of AIDS as national disaster in 1999 and declaration of total war on AIDS in 2002 as well as the enactment of new policies. External events include: United Nations declaration of commitment on AIDS; World Trade Organization's declaration on trade-related intellectual property rights and public health; creation of the Global Fund for AIDS; and, creation of the US's President's Emergency Plan for AIDS Relief. These events and related activities facilitated the development of governmental and nongovernmental responses that halted the epidemic's growth through condom distribution, HIV testing, and behavioral change and provision of treatment for people with AIDS.

Recommendations

National leadership, international supportive environment and collaborative interactions among institutional actors should be enhanced as a strategy for fostering effective response to AIDS.