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Journal of Public Health Advance Access originally published online on September 12, 2008
Journal of Public Health 2008 30(4):398-406; doi:10.1093/pubmed/fdn075
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© The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Are country reputations for good and bad leadership on AIDS deserved? An exploratory quantitative analysis



Nicoli Nattrass, Professor of Economics and Director of the AIDS and Society Research Unit at the University of Cape Town and Visiting Researcher in the Health Economics and HIV/AIDS Research Division at the University of Kwa-Zulu Natal
AIDS and Society Research Unit, University of Cape Town, Rondebosch, 7701 Cape Town, South Africa

Address correspondence to Nicoli Nattrass, E-mail: nicoli.nattrass{at}gmail.com


  Abstract

Some countries (e.g. Brazil) have good reputations on AIDS policy, whereas others, (notably South Africa) have been criticized for inadequate leadership. Cross-country regression analysis reveals that these ‘poster children’ for AIDS leadership have indeed performed better or worse than expected given their economic and institutional constraints and the demographic and health challenges facing them. Regressions were run on HAART coverage (number on highly active antiretroviral therapy as percentage of total need) and MTCTP coverage (pregnant HIV+ women accessing mother-to-child-transmission prevention services as percentage of total need). Brazil, Cambodia, Thailand and Uganda (all of whom have established reputations for good leadership on AIDS performed consistently better than expected—as did Burkina-Faso, Suriname, Paraguay Costa Rica, Mali and Namibia. South Africa, which has the worst reputation for AIDS leadership, performed significantly below expectations—as did Uruguay and Trinidad and Tobago. The paper thus confirms much of the conventional wisdom on AIDS leadership at country level and suggests new areas for research.

Keywords: geography, health services, socioeconomics factors


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