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HIV/AIDS policies in Mozambique and the new aid architecture: successes, shortcomings and the way forward*

Published online by Cambridge University Press:  18 May 2012

Eduardo Bidaurratzaga-Aurre*
Affiliation:
Department of Applied Economics I and HEGOA (Institute for the Study of Development and International Cooperation), University of the Basque Country (UPV/EHU), Spain
Artur Colom-Jaén*
Affiliation:
Department of Applied Economics, Autonomous University of Barcelona, Spain

Abstract

HIV/AIDS policies have become a significant and controversial issue in Mozambique in recent years. The extent of the disease, along with a massive involvement of the donor community and a committed response by Mozambican authorities, are the main drivers of these policies. In the framework of the new aid architecture, donors are expected to encourage recipient country ‘ownership’ of development policies through new aid instruments like budget support or sector-wide approaches. However, HIV/AIDS policies in Mozambique are highly influenced by donors, because an exceptionally high proportion of the financial resources and policy formation comes from them. In this article we assess the extent of HIV/AIDS and its effects in Mozambique, and analyse the successes and shortcomings of the policies to fight the disease, emphasising the role of donors. We end by exploring possible ways to increase ownership and effectiveness.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2012

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Footnotes

*

We are extremely grateful for the contributions of many health workers, members of bilateral and multilateral development agencies, and NGOs. These are too numerous to mention individually, but without their contribution this article would not exist. We also want to thank Bob Sutcliffe and the anonymous referees of this journal for their helpful comments and suggestions. The authors acknowledge complete responsibility for the content of the article.

References

REFERENCES

ABC. 2010. Catálogo ABC de cooperação técnica do Brasil para a África-2010. Brasilia: Agência Brasileira de Cooperação.Google Scholar
ADEA. 2003. The Challenge of Learning: improving the quality of basic education in sub-Saharan Africa. Paris: Association for the Development of Education in Africa.Google Scholar
AIM. 2011. ‘HIV/SIDA absorve mais de 50% do orçamento do Ministério de Saúde’, Agência de Informação de Moçambique, 16.2.2011, available at: www.portaldogoverno.gov.mz/noticias/news_folder_econom_neg/fevereiro-2011/hiv-sida-absorve-mais-de-50-do-orcamento-do-ministerio-da-saude/>, accessed 21.7.2011.,+accessed+21.7.2011.>Google Scholar
Ayisi, R. A. 2010. ‘Healers’ practices under the HIV spotlight’, International Press Service News Agency, Johannesburg 21.12.2010, available at: http://ipsnews.net/africa/nota.asp?idnews=35929>, accessed 13.7.2011.Google Scholar
Bennell, P. 2003. HIV/AIDS in sub-Saharan Africa: the growing epidemic. Brighton: Knowledge and Skills for Development.Google Scholar
Bidaurratzaga, E. 2007. ‘Desarrollo humano en África subsahariana: evolución y perspectivas de la educación y la salud’, in Oya, C. & Santamaría, A., eds. Economía Política del Desarrollo en África. Madrid: Akal, 5583.Google Scholar
Bidaurratzaga, E. 2011. ‘Progresos y desafíos para la salud en África subsahariana: la importancia de los sistemas nacionales de salud para los ODMs’, Revista de Economía Mundial 27: 3970.Google Scholar
CNCS. 2010. ‘Mozambique progress report 2008–2009’, United Nations General Assembly Special Session on HIV and AIDS. Maputo: CNCS.Google Scholar
Cohen, D. 2002. ‘Human capital and the HIV/AIDS epidemic in sub-Saharan Africa’, Working Paper 2, ILO Programme on HIV/AIDS and the World of Work. Geneva: ILO.Google Scholar
Collins, C. 2006. ‘Mozambique's HIV/AIDS pandemic: grappling with Apartheid's legacy’, Social Policy and Development Programme Paper 24, United Nations Research Institute for Social Development.Google Scholar
Coombe, C. M. 2002. ‘Mitigating the impact of HIV/AIDS on education supply, demand and quality’, in Cornia, G. A., ed. AIDS, Public Policy and Child Wellbeing. Florence: UNICEF Innocenti Research Centre, 1–38.Google Scholar
Cueto, M. 2004. ‘The origins of primary health care and selective primary health care’, American Journal of Public Health 94, 11: 1864–74.CrossRefGoogle ScholarPubMed
De Hulsters, B., Barreto, A., Bastos, R., Noya, A., Folgosa, E. & Fransen, L.. 2003. ‘Geographical focusing: an intervention to address increased risk for sexually transmitted diseases during repatriation and resettlement in post-war Mozambique’, Sexually Transmitted Infections 79: 77.CrossRefGoogle ScholarPubMed
Di Renzio, P. & Hanlon, J.. 2009. ‘Mozambique: contested sovereignty? The dilemmas of aid dependence’, in Whitfield, L., ed. The Politics of Aid: African strategies for dealing with donors. Oxford University Press, 246–70.Google Scholar
Dickinson, C., Martínez, J., Whitaker, D. & Pearson, M.. 2007. The Global Fund operating in a SWAp through a Common Fund: issues and lessons from Mozambique. London: HLSP Institute.Google Scholar
Elsey, H., Kilonzo, N., Tolhurst, R. & Molyneux, C.. 2005. Bypassing Districts? Implications of sector-wide approaches and decentralization for integrating gender equity in Uganda and Kenya. Oxford Universtity Press.CrossRefGoogle ScholarPubMed
Fiocruz, , 2010. ‘Lula e Temporão visitam instalações da fábrica que produzirá antirretrovirais’, Agência Fiocruz de Notícias, Rio de Janeiro 11.11.2010, available at: www.fiocruz.br/ccs/cgi/cgilua.exe/sys/start.htm?infoid=3644&sid=9, accessed 14.7.2011.Google Scholar
Handley, G. 2008. Mutual Accountability at the Country Level: Mozambique country case study. London: Overseas Development Institute.Google Scholar
Hanlon, J. 2004. ‘Do donors promote corruption? The case of Mozambique’, Third World Quarterly 25, 4: 747–63.CrossRefGoogle Scholar
International Labour Organisation (ILO). 2000. HIV/AIDS in Africa: the impact on the world of work. African Development Forum. Geneva: ILO.Google Scholar
ILO. 2006. HIV/AIDS and Work: global estimates, impact on children and youth, and response. Geneva: ILO.Google Scholar
Isaksen, J., Songstad, N. & Spissoy, A.. 2002. Socio-economic Effects of HIV/AIDS in African Countries. CMI Reports. Bergen: Chr. Michelsen Institute.Google Scholar
Kaarhus, R. & Rebelo, P.. 2003. CSOs and SWAps: the role of civil society organizations in the health sector in Mozambique. Maputo: NORAD.Google Scholar
Ministerio de Asuntos Exteriores y Cooperación (MAEC). 2005. Evaluación de la Cooperación Española en Salud en Mozambique. Informe de evaluación 18. Madrid: MAEC.Google Scholar
Magnussen, L., Ehiri, J. & Jolly, P.. 2004. ‘Comprehensive versus selective primary health care: lessons for global health policy’, Health Affairs 23, 3: 167–76.CrossRefGoogle ScholarPubMed
Manning, C. & Malbrough, M.. 2010. ‘Bilateral donors and aid conditionality in post-conflict peacebuilding: the case of Mozambique’, Journal of Modern African Studies 48, 1: 143–69.CrossRefGoogle Scholar
Martínez, J. 2006. ‘Implementing a sector wide approach in health: the case of Mozambique’, Technical Approach Paper. London: HLSP Institute.Google Scholar
Matsinhe, C. 2005. ‘“Tabula Rasa”: dinâmica da resposta Moçambicana contra o HIV/SIDA’. PhD thesis, Universidade Federal do Rio de Janeiro.Google Scholar
MISAU. 2004. Impacto Demográfico da Epidemia do HIV/SIDA nos Recursos Humanos do Sistema Nacional de Saúde em Moçambique. Maputo: MISAU.Google Scholar
Morfit, N. S. 2011. ‘“AIDS is money”: how donor preferences reconfigure local realities’, World Development 39, 1: 6476.CrossRefGoogle Scholar
Msuya, J. 2004. ‘Horizontal and vertical delivery of health services: what are the trade offs?’, background paper for World Development Report 2004/5. Washington, DC: World Bank.Google Scholar
Overseas Development Institute (ODI). 2002. Decentralization and Governance: decentralization and political accountability. London: ODI.Google Scholar
Organisation for Economic Cooperation and Development (OECD). 2008. Survey on Monitoring the Paris Declaration. Paris: OECD.Google Scholar
OECD-DAC. 2011. Creditor Reporting System/Aid Activity Database. Paris: OECD-DAC. Available at: http://stats.oecd.org/Index.aspx?DatasetCode=CRSNEW, accessed 18.7.2011.Google Scholar
Ooman, N., Bernstein, M. & Rosenzweig, S.. 2007. ‘Following the funding for HIV/AIDS: a comparative analysis of the funding practices of PEPFAR, the Global Fund and World Bank MAP in Mozambique, Uganda and Zambia’, Washington, DC: Centre for Global Development.Google Scholar
Peiffer, C. & Boussalis, C.. 2010. ‘Foreign assistance and the struggle against HIV/AIDS in the developing world’, Journal of Development Studies 46, 3: 556–73.CrossRefGoogle Scholar
Pita, J. I. (coord.). 2006. ‘Nuevos instrumentos de la cooperación española: la experiencia mozambiqueña’, Documento de Trabajo 2. Madrid: Fundación Carolina.Google Scholar
Sachs, J. 2001. Macroeconomics and Health: investing in health for economic development. Report of the Commission on Macroeconomics and Health (World Health Organisation). Harvard: Center for International Development.Google Scholar
Southern African Research and Documentation Centre (SARDC). 2000. Beyond Inequalities: women in Southern Africa. Harare: SARDC.Google Scholar
Schreuder, B. & Kostermans, C.. 2001. ‘Global health strategies versus local primary health care priorities: a case study of national immunization days in Southern Africa’, South African Medical Journal 91, 3: 249–54.Google ScholarPubMed
Sender, J., Cramer, C. & Oya, C.. 2005. ‘Unequal prospects: disparities in the quantity and quality of labour supply in sub-Saharan Africa’, Social Protection Discussion Paper Series. Washington, DC: World Bank.Google Scholar
Smith, S. & Cohen, D.. 2000. ‘Gender, development, and the HIV epidemic’, UNDP Issues Paper. New York: UNDP.Google Scholar
Sridhar, D. 2010. ‘Post-Accra: is there space for country ownership in global health?’, Third World Quarterly 30, 7: 1363–77.CrossRefGoogle Scholar
Tvedten, I., Paulo, M. & Montserrat, G.. 2008. Gender Policies and Feminisation of Poverty in Mozambique. Bergen: Chr. Michelsen Institute.Google Scholar
UNAIDS. 2008. Mozambique: country situation. Geneva: UNAIDS.Google Scholar
UNAIDS. 2010. Report on the Global AIDS Epidemic. Geneva: UNAIDS.Google Scholar
UNAIDS. 2011. AIDSinfo Country Fact Sheets: Mozambique. Available at: www.unaids.org/en/dataanalysis/tools/aidsinfo/countryfactsheets/, accessed 13.7.2011.Google Scholar
UNAIDS, WHO & UNDP. 2011. Using TRIPS flexibilities to improve access to HIV treatment. Available at: ww.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/JC2049_PolicyBrief_TRIPS_en.pdf, accessed 8.11.2011.Google Scholar
UNAIDS & WHO. 2008. Sub-Saharan Africa: situation of the AIDS epidemic. Geneva: UNAIDS & WHO.Google Scholar
United Nations Capital Development Fund (UNCDF). 2006. Mozambique Country Brief. New York: UNCDF.Google Scholar
United Nations Development Programme (UNDP). 2007. Mozambique National Human Development Report 2007: challenges and opportunities. The Response to HIV and AIDS. Maputo: UNDP.Google Scholar
UNDP. 2010. Human Development Report 2010. New York: UNDP.Google Scholar
UNDP. 2011. Human Development Report 2011. New York: UNDP.Google Scholar
UNDP-Mozambique. 2008. ‘Decentralization in Mozambique’, UN Internal Workshop. Maputo: United Nations Development Programme.Google Scholar
UNDP-Mozambique, 2011. Mozambique, the Mirror of Narcissus: knowledge and self-conscience for a better development of the Mozambican civil society. Maputo: UNDP-Mozambique.Google Scholar
UNESCO. 2011. Global Education Digest. Montreal: UNESCO Institute for Statistics.Google Scholar
Unger, J. P., De Paepe, P. & Green, A.. 2003. ‘A code of best practice for disease control programmes to avoid damaging health care services in developing countries’, The International Journal of Health Planning and Management 18: S27S39.CrossRefGoogle ScholarPubMed
Unger, J. P., De Paepe, P., Ghilbert, P., Soors, W. & Green, A.. 2006. ‘Disintegrated care: the Achilles heel of international health policies in low and middle-income countries’, International Journal of Integrated Care 6, 18: 113.Google ScholarPubMed
UNICEF. 2004. Girls, HIV/AIDS and Education. New York: UNICEF.Google Scholar
UNICEF. 2006. The State of the World's Children 2007. New York: UNICEF.Google Scholar
United States Agency for International Development (USAID). 2005. Corruption Assessment: Mozambique. Final report. Maputo: USAID.Google Scholar
World Health Organisation (WHO). 2006. The Health of the People: the African regional health report. Geneva: WHO.Google Scholar
WHO. 2008. Maximizing Positive Synergies between Health Systems and Global Health Initiatives. Geneva: WHO.Google Scholar
WHO. 2009. Interactions between Global Health Initiatives and Health Systems: evidence from countries. Geneva: World Health Organisation.Google Scholar
WHO. 2010. World Health Statistics 2010. Geneva: WHO.Google Scholar
WHO. 2011. World Health Statistics 2011. Geneva: WHO.Google Scholar
WHO-Africa. 2007. Report of the Internal Workshop on Primary Health Care and Health Systems. Brazzaville: WHO Regional Office for Africa.Google Scholar
WHO & UNAIDS. 2009. Mozambique: 2008 Update. Epidemiological fact sheet on HIV and AIDS. Geneva: WHO & UNAIDS.Google Scholar
World Bank. 2002. Education and HIV/AIDS: a window of hope. Washington, DC: World Bank.Google Scholar
World Bank. 2011. World Development Indicators 2011. Available at: http://data.worldbank.org/data-catalog/world-development-indicators/wdi-2011, accessed 14.7.2011.Google Scholar
World Trade Organisation (WTO). 2001. Declaration on the TRIPS Agreement and Public Health. WTO Ministerial Conference. Doha, 9–14.11.2001.Google Scholar