ABSTRACT
D. Sanders and A. Sambo maintain that the population at risk of Acquired Immunodeficiency Syndrome (AIDS) is increased directly by urban migration, poverty, women’s powerlessness, and prostitution, and indirectly through a decrease in health care provision. This is the political ecology of AIDS—the social and economic context of the spread of Human Immunodeficiency Virus (HIV)/AIDS in Africa. This chapter reviews developments in the spread of AIDS in the context of the changing political economy of Africa. It outlines AIDS among health problems and the financial straits of African health service delivery systems and looks particularly at the service problems arising from the 1987 and 1993 World Bank recommendations for the privatization of health care. The International Monetary Fund and the World Bank should take responsibility for the part austerity measures and structural adjustment programs have played in the spread of HIV in Africa.
