209541 AIDS Policy Development in Kenya: A Historical Institutionalist Analysis

Monday, November 9, 2009

Alex Otieno, MPH, PhD c , Department of Sociology, Anthropology and Criminal Justice, Arcadia University, Glenside, PA

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.


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

Learning Objectives:
Explain Kenya's emergence as a success story in responding to AIDS during the mid 2000s after a slow and ineffective response in the 1980s and 1990s

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have presented before and have also organized, presided over and been discussant at sessions in other conferences.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.