ABSTRACT
The chapter pursues its aim of showing how the World Bank has set and sustained the global agenda for HIV/AIDS by fi rst looking at the decline of the WHO and the relationship between the Bank, UNAIDS and the UN system. Second, the chapter then looks at how the MAP underpins the central mechanisms and approach to HIV/AIDS governance of the Global Fund, before considering the relationship between the current system and bilateral actors such as the US government’s PEPFAR programme and the rise of philanthropic foundations, principally the Bill and Melinda Gates Foundation. Third, the chapter explores how the problems and contentions found within the MAP at the state level are replicated at the global level of institutional interaction, and the ramifi cations of this for effectively responding to the HIV/AIDS epidemic. Fourth, The chapter outlines how, despite the Bank seemingly withdrawing from HIV/AIDS in sub-Saharan Africa, the Bank’s infl uence is extending in other ways within these countries, and how the framework of the MAP continues to be exported throughout the Caribbean. As such, the chapter argues that through a combination of timing and establishing structures within health systems at the country-level through the
MAP, the Bank has established and sustained the working structures of the global HIV/AIDS response.
