The role of local government in combating HIV/AIDS in South Africa: An institutional analysis
Master Thesis
2007
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University of Cape Town
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Abstract
To date the South African government's HIV/AIDS response has been largely focused at the national and provincial level. This response has been largely ineffective despite significant increases in funds allocated to combating the epidemic. In addition, local government's role has been effectively ignored even though the ongoing process of transformation is broadly aimed towards a more decentralised government. However, the theoretical evidence shows that the local sphere is crucial to an effective and efficient response. Fiscal federalism theory suggests that while the macroeconomic stabilisation and income distribution functions are most appropriately discharged at central government level; the allocative function is best accomplished by local government. Thus at the local level, where decentralisation encourages competition between local governments, HIV/AIDS responses would tend to be more dynamic and innovative, as well as designed specifically to meet the specific characteristics of a particular district. Although there may be an argument that the merits for a decentralised approach are mostly normative, the empirical evidence also tends to be supportive. The effects of HIV/AIDS are mostly felt at the local level, with family members of people living with or dying from HIV/AIDS being the hardest hit by its effects. Also in dealing with HIV/AIDS, successful responses internationally have largely been at the local level, giving further support to a more decentralised HIV/AIDS response. The national government has significantly increased budget allocations for the fight against HIV/AIDS. Further increased funding may not be necessary if a decentralised approach is supported by local institutions which encourage good governance, and support the development of partnerships with key stakeholders where capacity and skills are lacking within local government. These same institutional arrangements would help ensure that increased funding actually does translate into service delivery to affected communities.
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Includes bibliographical references (leaves 69-78)
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Albertus, A. 2007. The role of local government in combating HIV/AIDS in South Africa: An institutional analysis. University of Cape Town.