Not business as usual: Public sector responses to HIV/AIDS in Southern Africa

It is becoming clear that the implications of HIV/AIDS will increasingly impact on virtually all aspects of society. By significantly undermining human resources in severely affected regions like Southern Africa, it is anticipated that the epidemic will impact on both the demand for government services and their supply, with a number or analysts speculating that HIV/AID will dramatically reduce the ability of government institutions, in particular, it is argued that suych erosions of capacity will occur in the face of increasing HIV/AIDS-related demands for services-whittling avays public sector capacity precisely when it is needed most to combat the effects of the epidemic. The ultimate implications of the epidemic, however, are likely to be bound up with issues of original capacity and effectiveness and, crucially, the extent to which institutions acknowledge HIV/AIDS as a problem and put in place measures to mitigate its effects. Drawing on best practice from the private and, to a lesser extent the public sector, this book explores the extent to which government institutions in the region have put in place comprehensive responses to the epidemic, the efficacy of present activities, and the factors influencing heir effectiveness. It documents the findings of three institutional case studies conducted in Botswana, Lesotho, and Malawi in the first quarter of 2004. Specific issues explored include:. -the discernable impact of HIV/AIDS on the institutions in the context of existing service delivery capacity; the extent to which institutions have developed appropriate mitigation strategies; the extent to which such strategies have been implemented; and the reasons for this, including facilitating factors, blockages, and constraints to implementation. The findings suggest that high levels of seemingly AIDS-related attrition are exacerbating existing organizational and resource constraints to delivery. Anecdotal evidence indicates that illness, absence, and death of staff have resulted in productivity losses, failure to meet obligations and, in some cases, wasting of resources. In development-oriented.