| |
| author |
Kyle Nolan
| | title |
HIV/AIDS in Southern Africa: A Comparative Analysis of Governance and the Self-Sufficiency of HIV/AIDS Responses in South Africa, Zimbabwe, and Namibia
| | abstract |
HIV/AIDS is a disease which has long affected the globe and been a burden of public
health. Southern Africa has been a region that currently and historically disproportionately has
been affected by HIV/AIDS, with extremely high incidence and prevalence, especially when
compared to both other regions and the globe at large. To combat the HIV/AIDS pandemic the
United States and others have long provided foreign aid to recipient countries, with many
Southern African countries being natural recipients of said aid. Now, however, foreign aid for
HIV/AIDS has experienced significant cuts from the United States, threatening the public health
of many recipient countries who rely on said aid. Because of this, there is a growing concern
over the HIV/AIDS program sustainability and self-sufficiency within these recipient countries,
especially in Southern African countries. To answer how effective and self-sufficient Southern
African countries are in managing their HIV/AIDS epidemic and how they can improve, this
thesis seeks to explore what self-sufficiency in HIV/AIDS epidemic response looks like and what
factors contribute towards its development in Southern Africa. This thesis begins with a review
of the current HIV/AIDS foreign aid system, the role of the United States, and the recent decline
in HIV/AIDS foreign aid, ultimately concluding that the previous levels of foreign aid towards
HIV/AIDS are now unfeasible. This is followed by a literature review which goes over multiple
articles discussing the current foreign aid system, why the current aid system is flawed and
encourages aid dependency, and how the aid system can be reformed by giving more
responsibility to recipient countries and improving domestic government institutions. The thesis
then compares three Southern African countries, South Africa, Zimbabwe, and Namibia,
examining both their history, epidemic incidence and prevalence, HIV/AIDS spending and
financial self-sufficiency, and scores on the six World Bank’s Worldwide Governance Indicators.
This is followed by a series of multiple regressions, one for each country, using the six
Worldwide Governance Indicators as predictors of HIV/AIDS self-sufficiency, with HIV/AIDS
self-sufficiency measured as a percentage of total HIV/AIDS spending within that country from
domestic government sources. Ultimately the results of the country comparison indicate that all
countries are significantly suffering from the HIV/AIDS pandemic, but in the management and
trajectory of their epidemics both South Africa and Namibia are faring better than Zimbabwe in
their response and financial self-sufficiency, along with their higher governance scores. This is
despite Namibia and Zimbabwe being categorized as lower-middle income economies and South
Africa as an upper-middle income economy, indicating a lower importance of overall country
wealth than what would be assumed in governance and epidemic response. In addition from the
multiple regression it is evident that the Worldwide Governance Indicators have strong
correlation with financial self-sufficiency, and specifically the value of the indicators of political
stability, regulatory quality, control of corruption, and government effectiveness as predictors of
financial self-sufficiency. Ultimately this thesis concludes from the literature review, country
comparison, and multiple regression that a self-sufficiency is necessary for the future response to
the HIV/AIDS pandemic, that governance ability is vitally important in creating a self-sufficient
HIV/AIDS response, and that in the future foreign aid should focus on improving recipient
country governance capabilities to ensure the long term sustainability of the HIV/AIDS response.
For future study this thesis suggests the use of the methods in this thesis to create a model which
uses all country recipients of HIV/AIDS support and their data from a single year, which could
create results that could be applied more universally.
| | school |
The College of Liberal Arts, Drew University
| | degree |
B.A. (2026)
|
| advisor |
Phoebe Mengxiao Tang
|
| full text | KNolan.pdf |
| |
