ABSTRACT
The HIV/AIDS epidemic is one of the most catastrophic phenomena that has impacted and will continue to impact people’s lives in Sub-Saharan Africa. According to UNAIDS in December 2005 an estimated 40.3 million people are living with HIV. Around 25.8 million of these are living with the disease in Sub-Saharan Africa. In 2005, 3.2 million people contracted HIV (UNAIDS 2005a: 2-3).1 The epidemic is generalised largely in eastern and southern Africa, influencing all aspects of society. It also seems to be intensifying in southern Africa (UNAIDS 2005a: 4). In addition, there are predictions that estimate a steady increase in the infection rates in the years to 2010 in many countries. This includes western Africa, where numbers at present are not as high as in other parts of Africa. These terrible numbers do not reflect lack of attention. Far from it, the problem has been given importance in the international development and aid policy agendas for the best part of the last ten years. International funding for interventions has been gradually increasing for the region. This has been boosted by the Bush administration’s US$15 billion pledge to 12 African and two Caribbean countries for HIV/AIDS interventions over five years from 2003. The aim is to support treatment and prevention in the designated countries. Despite controversy over its focusing on abstinence as a prevention method, the funding presents a major contribution to the global attempts. Considered in relation to projections of UNAIDS, which forecast a US$3.07 billion requirement by 2005 for SubSaharan Africa in order to provide care and support for those who are in need, the US contribution is of considerable importance. It is at this point that the question of internationalisation of the policy frameworks that gives a global outlook to HIV/AIDS becomes important. To analyse this, the chapter first looks at the process of internationalisation and how this process has created a governance system for HIV/AIDS policies. Here, the aim is to unpack the role of governance structure in influencing the behaviour of particular actors. Then it highlights some effects of this system as expressed by people who are targeted by the policies.
