ABSTRACT
A central mechanism for making governance of the HIV/AIDS response more participatory and accountable to people living with and affected by the epidemic has been the introduction of a multisectoral approach. The socioeconomic determinants of HIV/AIDS within countries with high prevalence rates require a varied and disaggregated response to the epidemic that encompasses all aspects of society – from teachers, religious leaders and local government, to the international organisations and donors that fund their projects. The need to adopt this approach, and to encourage other aspects of society to participate in tackling the spread of HIV/AIDS underpins the concept of multisectorality: the idea that to fight HIV/AIDS, you need to involve all of society. This chapter looks at the origin of multisectorality, and how it has been
harnessed and promoted by the World Bank as a means of participatory governance in the response to the HIV/AIDS epidemic. It will unravel some of the contradictions and problems with this approach in practice, what this means for accountable and participatory governance of HIV/AIDS, and how we can understand the role of international organisations and processes of global governance through the World Bank. The chapter does so by looking at the impact of the Bank’s Multi-Country AIDS Programme (MAP) with specific reference to Kenya, Tanzania and Uganda.3 It pursues this aim by first explaining what the World Bank means by multisectorality, and why and how the Bank has come to occupy a central role within HIV/AIDS governance. Second, the chapter briefly builds on Chapter 4 of this book, by explaining the contours of multisectorality within the MAP. Third, the chapter discusses some of the successes and limitations of the Bank’s approach to
multisectorality in promoting participation and accountability. In so doing, it draws together the consequences of multisectorality on the HIV/AIDS response in conclusion.
