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Bottlenecks and Benevolence

How the World Bank is Helping Communities to ‘Cope’ with HIV/AIDS

Sophie Harman is Lecturer in International Politics at City University, London.

This article looks at how Goal 6 of the United Nations (UN) Millennium Development Goals (MDGs) impacts on the well-being of the people affected by Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS). The focus is on a specific aspect : how the aid emphasised by Goal 6 is channelled towards community groups responding to the HIV/AIDS crisis. It does so by exploring the institutional mechanisms used by one of the key international organisations involved in the realisation of the MDGs—the World Bank and its Multi-Country HIV/AIDS Programme (MAP) in Kenya, Tanzania and Uganda. The article explores the role of local government, rivalry between different forms of civil society organisations, the problems associated with effective delivery and community feedback, donor responses to these problems and how these factors impact upon the immediate and long-term realisation of Goal 6, and the position of communities within it. Key to which are themes of conditionality and divisions between implementation and decision-making. The article is based upon extensive qualitative research into MAP in East Africa.

Journal of Health Management, Vol. 11, No. 2, 297-313 (2009)
DOI: 10.1177/097206340901100203


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