CHARLESUNIVERSITY
FACULTY OF SOCIAL SCIENCE
DEPARTMENT OF PUBLIC AND SOCIAL POLICY
THE MAGNITUDE OF GOVERNANCE IN ADDRESSING HIV/AIDS PROBLEMS IN ETHIOPIA
DANIEL MESSELE BALCHA /MA/
Supervisor: Prof. PhDr. Martin Potůček, CSc., MSc.
May 2009
Table of Contents Page
Executive Summary------3
1.Introduction------4
1.1.Background of the Study ------4
1.2.Research Question ------6
1.2.1.Hypothesis I------7
1.2.2.Hypothesis II------8
1.2.3.Hypothesis III------8
1.3.Objectives of the Study ------9
1.4.Significance of the Study------10
1.5.Delimitation of the Study------10
2.Methodology------10
2.1.Study Area, Population and Sampling------11
2.2.Tools of Data Collection------12
2.3.Methods of Data Analysis------12
3.Literature Review------12
3.1.Normative Models of Public Policy------12
3.2.Formation and Implementation of Public Policy------15
3.3.Pluralism ------16
3.4.Partnership------16
3.4.1.Partnership Experience in Addressing HIV/AIDS in Ethiopia------18
3.5.Governance------19
3.6.Legal Framework------21
3.6.1.The New NGO Law in Ethiopia------22
3.7.Social Capital------23
3.8.Actors------25
3.8.1.Major Actors and Their Respective HIV/AIDS------25
3.9.Conclusion ------26
4.Overview of Ethiopia------29
4.1.Historical Overview------31
4.2.Current Trends, Intervention Mechanisms and Programs------32
4.3.Key Challenges------33
Reference
The Magnitude of Governance in Addressing HIV/AIDS Problems in Ethiopia
Key words: partnership, social capital, HIV/AIDS, Ethiopia, governance
Executive Summary
The HIV/AIDS problem is one of the major problems exhibited in Ethiopia. Though different efforts are being made to address the issue the lack of efficient partnership among the major actors and legislative, cultural, administrative, financial and other barriers are sometimes suggested as the major drawbacks. As a result there seem to be uneven share of the government, civic and business sector in addressing the problem. More recently, we see unintended effects of the new NGO law in addressing the problem of HIV/AIDS. Therefore, this study anticipates developing an ideal model of public policy towards HIV/AIDS in Ethiopia and identifies the major barriers of practicing it. This is done by analyzing the normative models of public policy and the concepts related to governance, partnership and social capital.
Why governance, social capital and partnership then? Since the 1980’s the governance literature referred to the term as inclusion of civil society actors. It encouraged states to work together in various issues. For instance, Rhodes (1997a:15) states that: “Governance refers to self-organizing, interorganizational networks characterized by interdependence, resource-exchange, rules of the game, and significant autonomy from the state.” Also Dror (2001) suggests that governance increases collective capacity to influence the future for the better. Additionally, the EU new modes of governance concept also promotes the involvement of civil society actors including the private actors in various social issues. For instance, while studying the role of new modes of governance in EU enlargement, Börzel (2007) referred to the term as the making and implementation of collectively binding decisions that “are not hierarchically imposed, i.e. each actor involved has a formal or de facto veto in policy-making and voluntarily complies with the decisions made, and systematically involve private actors, for profit (e.g. firms) and/or not for profit (e.g. non-governmental organizations) in policy formulation and/or implementation.” These signify the importance of partnership and that of social capital, which is defined as “the ability of people to work together for common purposes in groups and organizations” (Fukuyama, Francis. (1995:10)). The multi – dimensional concept of governance, which mainly includes vertical layers of governance, regulators – market, state, and civic sector; and actor’s networks and networking is used to understand the public policy making and implementation. Potůček (2004, 2006).
Therefore, using these concepts, the role of the state particularly in line with pluralism is analyzed. The state private sector governance is considered while formulating the public policy model among the public sector and the private sector, which includes both the business sector and the civic sector at different stages of public policy formulation and implementation. Actor-centered theory is used to analyze the actors’ capacity and how they impose their preferences in the process. Additionally, this qualitative case study makes use of the processes of social policy, where the capacity to coordinate and implement social policies will be emphasized. The corporatism perspective is used to analyze the role of the state in the whole of societal reproduction and the forms of the relationship between the state and the interest groups. The necessary data will be collected by using document analysis and interview techniques.
1.Introduction
1.1.Background
One of the major things lacking in the developing world today is lack of governance, which ensures and recognizes the role of the civic sector in addressing social problems. There exists unclear cooperation between the state and the civic sector. The developing world mainly Africa is challenged with a lot of social problems. HIV/AIDS stands first. In addressing these problems the partnership among the state, civic sector and that of business sector is mandatory. One thing is the lack of capacity of the state to meet these challenges. The other is lack of well defined environment where different stake holders function for achieving a common goal. Therefore, at these stake times promoting the relevance of governance, which provides the chance for more coordinated responses and also sharing of resources at different levels, is essential to address significant social problems. By its very definition, governance is, “how governments and other social organizations interact, how they relate to citizens, and how decisions are taken in a complex world. Thus governance is a process whereby societies or organizations make their important decisions, determine whom they involve in the process and how they render account.”(Graham, J., et al, (2003))
Based on the experience from the CzechRepublic and other Central and Eastern European countries, one of the good governance criteria Potůček (2004:91) mentions is communication in the public space. He states that
“public administration effectiveness is inseparably linked with a vibrant civil society (without which fair and efficient policy is less likely). Administration carried out by Government only is not able and capable to respond adequately to the real needs of the people in many areas of public policy. Governments must search for partnership, cooperation, and joint decision-making with the civic sector.”
From these we understand that partnership is important not only while implementing programs but also in decision making.
When college students were asked, “What are the major social problems facing humanity today?” Their responses mirrored those highlighted by the mass media like AIDS, child abuse, poverty, war, famine, racism, crime, riots, the state of the economy, etc. (Widdison and Richard (1993:2)). For such and other major social problems scholars across the spectrum try to understand the problems and seek solutions. As a result, they tend to divide into three major theoretical camps: symbolic interactionism, functionalism, and conflict theory. Where, symbolic interaction perspective argues that a social condition is a social problem until a significant number of politically powerful people agree that it is contrary to the public good. It is not the social condition, but how the condition is defined and by whom, that determines if it is or become a social problem. Functionalists argue that society is a social system consisting of various integrated parts. Each of these parts fulfills a specific role that contributes to the overall functioning of society. When any part fails, this creates a problem for the whole. These failures upset the equilibrium of the system and become social problems. Where as, the conflict theorists see social problems as the natural and inevitable consequences of groups in society struggling to survive and gain control over those things that can affect their ability to survive. (Ibid (1993:4-6))
Understanding a certain problem or something contrary to the public good is essential for various actors especially by those politically powerful people as seen in the symbolic interactionism camp. The functionalist view also provides significant perspective to understand the problem. Since, it provides, an opportunity to assess the different components of a social system. This helps both the state and other actors to assume their role in the over all functioning of the society. The conflict perspective also helps the state to assume the traditional functions of maintaining law and order. Therefore, having this in mind this study tries to provide a public policy analysis providing due consideration for these perspectives, which includes the understanding of HIV/AIDS problem by those people or actors concerned and their respective role in addressing the problem.
1.2.Research Question
People living in the world have various challenges. The challenges they face are also different from one place to the other. People in some places suffer from lack of basic needs and services while others look for the best ways of providing them. Various groups of communities living in developing countries are disadvantaged due to poverty in general and social problems in particular. Among the rest HIV/AIDS is the major one that countries like Ethiopia face today. For instance, HE Girma Wolde Giorgis, President of the Federal Democratic Republic of Ethiopia in 2004 expressed the magnitude of the problem as,
“Our cemeteries are filled beyond capacity. Parents are dying from HIV/AIDS or burying their children; a generation of fathers and mothers is being lost leaving the grandparents to grieve and raising the next generation. I cannot understate the terrible nature of the crisis that is enveloping our societies. As bad as it is today, the reality is that it is getting worse.”[1]
Though different actions are being taken, it is hard to say promising achievements are there. According to the recent single point HIV prevalence estimate issued in 2007, the total adult and children prevalence rate is still increasing and will also increase in the years to come.[2] The lack of efficient partnership and legislative, cultural, administrative, financial and other barriers are sometimes suggested as bottle necks for the proper implementation of HIV/AIDS programs. Having this in mind, the research focuses on policy issues related to HIV/AIDS, especially the formation and implementation of public policy in addressing HIV/AIDS problems. Accordingly, the research has developed the following three research hypothesis, which will be analyzed using empirical data and the theoretical framework.
1.2.1.Hypothesis I
Due to the complicated nature of the HIV/AIDS problem apart from the policy, professional, efficient and timely activities need to be implemented. Though various programs are being carried out by multi national organizations including the UNAIDS, governmental authorities and non governmental organizations to address the HIV/AIDS problem, most of these programs are mainly focused on improving the access of the disadvantaged communities to basic social services. They are also engaged in various awareness and advocacy works. But due to the magnitude and multisectoral problems associated to HIV /AIDS there is a strong need of coordinated efforts to tackle the problem. Therefore, the individualistic nature of addressing the problem and even sometimes the manifestation of competitions among NGOs has contributed for the inefficient partnership among different actors.
Therefore, the individualistic nature of implementation and competition among specially NGOs on beneficiaries and financial resources have resulted in partnership failure, which has affected the multi sectoral approach of addressing the problem. As it can be seen from the very title, what is meant by the word magnitude emphasizes this research issue. That is, it seeks to analyze the level or functioning of the existing partnership among different actors in addressing HIV/AIDS problems in the country. Secondly, it would like to come up with a conceptual framework, which emphasizes the importance of the governance approach as it assumes the wide variety of public, private and civil society actors affect social problems. (Bekkers, et. al (2007)).
1.2.2.Hypothesis II
Most recently, in January 2009, the Ethiopian Parliament adopted a controversial new law which could both give control to the government over NGO activities, and also criminalize the work of human rights defenders. The law criminalizes human rights activities undertaken by national organizations that receive more than ten percent of their funding from abroad. It also criminalizes human rights activities by foreign NGOs, including campaigning for gender equality, children's rights, disabled persons' rights and conflict resolution. By its very nature HIV/AIDS problem is a human right issue. And even the HIV/AIDS policy, itself suggests mainstreaming the activity with various endeavors. Moreover, both the local and international NGOs finance their programs related to HIV/AIDS through the funding they get through human right projects. Also HIV/AIDS programs directly benefit from the administrative costs covered by other projects targeted by this specific legislation. Therefore, we observe both implicit and explicit effect of the new NGO law in addressing the problem of HIV/AIDS, which will result in unintended consequences in addressing the problem.
1.2.3.Hypothesis III
In August 1998, the Ethiopian government has approved the National HIV/AIDS Policy. The policy has the overall objective of providing an enabling environment for the prevention and alleviation of HIV/AIDS. Though the policy is in place for more than 10 years now, recent data show that the prevalence is still increasing. For this, cultural traditions and the lack of financial resources affect the administrative functions and the attitudes and behaviour of the population, which in turn affect the policy implementation. One basic reason for this failure is the lack of governance, which mainly puts the government in the center of every activity. That is, it exhibits unicentric system of government instead of pluricentric system. Also it gives much more emphasis on the structure of government instead of the process of governing. That is, command and control instead of negotiation and cooperation. (Bekkers, et. al (2007))
Consequently, less social capital is exhibited. This in turn led to greater tendency to rely on authoritative controls and it is more difficult to mobilize the support needed to address the problem. The lack of social capital, which resulted from the above mentioned reasons, also contributed to the lack of confidence in government and other actors involved. In general, due to this inconvenient environment to enhance social capital there seem to be less participation in voluntary associations and capacity of problem-solving outside the governmental sector.
In other words, there is minimal participation of the business and civil society sector in the public policy formation process towards HIV/AIDS. NGOs seem to be active in the implementation of various programs whereas very little participation by the business sector is exhibited. In short, there is uneven and insufficient share of the government, civic and business sector in addressing the problem.
1.3.Objectives of the Study
The study tries to analyze the existing ways of responding to the HIV/AIDS problem with a special focus on the formation and implementation of public policy in addressing HIV/AIDS problem. In particular, it has the following three major objectives.
- Develop an ideal model of public policy towards HIV/AIDS in Ethiopia.
- Identify the major factors affecting the formation and implementation of public policy in addressing HIV/AIDS problems.
- Explore the partnership patterns among NGOs, GOs and the private sector in addressing the problem and identify the major challenges and their consequences.
By targeting on these objectives, the study aims at advocating partnership in line with the governance concept to address the HIV/AIDS problem. Therefore, it analyzes literature showing the importance of partnership mainly between the state and the civic sector at different levels. Attempt is also made to show the relevance of the private sector. It will also discuss some of the challenges that this partnership faces.
1.4.Significance of the Study
The research helps to explore the country's HIV/AIDS experience in line with the extent to which the formation and implantation of HIV/AIDS policy has been effective by explaining knowledge and skills corresponding to the newest development trends in the discipline of public and social policy. The policy, approaches and methodologies employed to manage the problem will be analyzed in order to see its effectiveness with the specific groups under question. This helps the organizations engaged in the provision of social support and development of social programs as a feedback for their activities. It paves the way for efficient policy development and implementation strategies to solve the HIV/AIDS problem. It can also be used for advocacy purpose since it will assess the process from the policy level up to the implementation level with especial emphasis on partnership. Additionally, it can be used by other organizations engaged in social policy and development research as a source of information.