ABSTRACT
To see how the World Bank has set the global agenda and what this agenda looks like, it is important to trace the antecedents of multi-sectoralism and the World Bank’s involvement in HIV/AIDS. Multi-sectoralism has its origins in processes of civil society engagement within the Bank. These processes stem from how the World Bank has developed as an institution that is adaptable to change in response to internal and external pressure, while promoting the same market-oriented approach to carrying out development. Its role in global health, HIV/AIDS and multiple issues affecting countries in sub-Saharan Africa are grounded in the Bank becoming the lender of fi rst resort in its role as lender of last resort where it funds development issues that no other organisation will. State-led governance reform is not a new phenomenon within the Bank but something that has been instilled within the institution since its inception. This is crucial to understanding the Bank, the MAP and HIV/AIDS governance, as the Bank is able to promote multi-sectoral partnerships and state responsibility while maintaining its role as a non-political actor as enshrined in its founding principles. It is these founding principles and their interpretation within the comprehensive development agenda and projects such as the MAP that continue to underpin the Bank’s governance reform agenda and the use of economic incentive as a means of promoting liberal reform. The Bank’s ability to adapt and establish itself as a leader in development knowledge not only explains the origins of the MAP in relation to its ability to adapt but explains how the Bank established itself as a leader in global health governance. Central to which is how HIV/AIDS policy has adapted within the institutional context of the Bank: from models of best practice emanating from Brazil, to specifi c individuals framing the agenda in accordance with the central principles of good governance reform. This chapter outlines the origins and institutional factors that underpin the Bank’s multi-sectoral agenda towards HIV/ AIDS, and demonstrates how governance reform and global health interventions are not new for the Bank but a logical progression of institutional development from the Bank’s inception that constrains methods of combating HIV/AIDS that do not have an economic incentive or liberal outcome.
