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Doomed Interventions

Book description

Between 2002 and 2013, bilateral donors spent over $64 billion on AIDS intervention in low- and middle-income countries. During the same period, nearly 25 million died of AIDS and more than 32 million were newly infected with HIV. In this book for students of political economy and public policy in Africa, as well as global health, Kim Yi Dionne tries to understand why AIDS interventions in Africa often fail. The fight against AIDS requires the coordination of multiple actors across borders and levels of governance in highly affected countries, and these actors can be the primary sources of the problem. Dionne observes misaligned priorities along the global chain of actors, and argues this misalignment can create multiple opportunities for failure. Analyzing foreign aid flows and public opinion polls, Dionne shows that while the international community highly prioritizes AIDS, ordinary Africans view AIDS as but one of the many problems they face daily.


‘In this sophisticated and insightful book, Kim Yi Dionne illuminates the challenges to global intervention against AIDS in Africa. With multi-method research and rich data, Dionne convincingly shows the disconnect between the priorities of international donors and the intended beneficiaries of aid and she argues that global intervention is undermined when donor priorities are privileged over citizens' priorities.'

Dominika Koter - Colgate University, New York

‘Dionne uses fascinating cases across a number of sub-Saharan African countries to demonstrate how the mismatch between donor and citizen priorities limits the effectiveness of HIV programming, as does the sheer number of actors involved at multiple levels of governance. One of the book's key contributions is its attention to AIDS interventions at the subnational level, particularly the role of village headmen, which Dionne situates with rich detail in what she aptly calls the global supply chain of AIDS interventions.'

Rachel Sullivan Robinson - American University, Washington, DC

‘Drawing on extensive fieldwork in Malawi, Dionne offers a provocative warning to the international AIDS community about the dangers of pushing policies without sufficient consultation and buy-in from local people who may have other priorities. This book will be of great interest to AIDS experts and development practitioners alike.'

Joshua Busby - LBJ School of Public Affairs, University of Texas, Austin and author of AIDS Drugs for All: Social Movements and Market Transformations (with Ethan Kapstein)

‘Despite the massive investment of international donors to support HIV/AIDS programs in Africa, there has been far too little investigation of the politics of the allocation of these resources. Building off more than a decade of research, Kim Yi Dionne fill this gap by demonstrating how the priorities of global health donors are oftentimes misaligned with those who benefit from these programs (citizens) and those who are often engaged implement these programs (communities). She demonstrates how misalignments of priorities have contributed to poor program outcomes and likely poor health outcomes. Notably, her book shines an important light on the little understood role of village headmen in Malawi in the fight against HIV/AIDS. The implications of her work are clear and apply to all global health programs, donors need to invest more to better understand the needs of citizens to make better use of stagnating global health aid.'

Karen A. Grépin - Wilfrid Laurier University, Ontario

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