National responses to global health targets
Exploring policy transfer in the context of the Unaids ‘90–90–90’ treatment targets in Ghana and Uganda
Bibliographic Data
Global health organizations frequently set disease-specific targets with the goal of eliciting adoption at the national-level; consideration of the influence of target setting on national policies, programme and health budgets is of benefit to those setting targets and those intended to respond. In 2014, the Joint United Nations Programme on HIV/AIDS set 'ambitious' treatment targets for country adoption: 90% of HIV-positive persons should know their status; 90% of those on treatment; 90% of those achieving viral suppression. Using case studies from Ghana and Uganda, we explore how the target and its associated policy content have been adopted at the national level. That is whether adoption is in rhetoric only or supported by programme, policy or budgetary changes. We review 23 (14 from Ghana, 9 from Uganda) national policy, operational and strategic documents for the HIV response and assess commitments to '90-90-90'. In-person semi-structured interviews were conducted with purposively sampled key informants (17 in Ghana, 20 in Uganda) involved in programme-planning and resource allocation within HIV to gain insight into factors facilitating adoption of 90-90-90. Interviews were transcribed and analysed thematically, inductively and deductively, guided by pre-existing policy theories, including Dolowitz and Marsh's policy transfer framework to describe features of the transfer and the Global Health Advocacy and Policy Project framework to explain observations. Regardless of notable resource constraints, transfer of the 90-90-90 targets was evident beyond rhetoric with substantial shifts in policy and programme activities. In both countries, there was evidence of attempts to minimize resource constraints by seeking programme efficiencies, prioritization of programme activities and devising domestic financing mechanisms; however, significant resource gaps persist. An effective health network, comprised of global and local actors, mediated the adoption and adaptation, facilitating a shift in the HIV programme from 'business as usual' to approaches targeting geographies and populations.
Business · Context (archaeology) · Developing country · Economic growth · Economics · Geography · Health care · Policy transfer · Political science · Public relations · Rhetoric · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Policy Transfer and Learning · Public Administration · Health Policy
Generation of political priority for global health initiatives
Retention in HIV Care between Testing and Treatment in Sub-Saharan Africa
Financing the Millennium Development Goals for health and beyond
Who Learns What from Whom
A framework on the emergence and effectiveness of global health networks
Impact of Targeted Programs on Health Systems
Ethical dilemmas in current planning for polio eradication
Financing the HIV response in sub-Saharan Africa from domestic sources
The French General Election of March 1973 in Marseilles
Learning from Abroad
| Citations per year | 0.75 |
|---|---|
| Citation span | 2022 - 2025 (4) |
| Highly cited | No |