Skip to main content
Erschienen in: Policy Sciences 1/2011

01.03.2011

Deadly divide: Malawi’s policy debate on HIV/AIDS and condoms

verfasst von: Paul Mkandawire, Isaac N. Luginaah, Rachel Bezner-Kerr

Erschienen in: Policy Sciences | Ausgabe 1/2011

Einloggen

Aktivieren Sie unsere intelligente Suche, um passende Fachinhalte oder Patente zu finden.

search-config
loading …

Abstract

This paper examines the dynamics of condom policymaking in Malawi by analyzing debates, which took place in the Malawi National Assembly between the year 2000 and 2004. Using content analysis and key informant interviews, and situating the overall discussion within policy and science literature, we examine how scientific evidence is being applied in the policymaking process as it relates to the place of condoms within the context of HIV/AIDS prevention. The study not only shows the extent to which the policymaking process on condoms in Malawi largely embodies a tendency to blur the conventional divide between science and politics, but also demonstrates why controversy around condoms still persists at the highest level of government in a country with one of the highest HIV prevalence rates in the world. It was found that even when people are dying, consensus in HIV/AIDS policymaking can be difficult to achieve in a policy climate characterized by a binary perspective to social problems, and where different actors compete for control over the policy terrain. The paper makes recommendations that may be helpful in facilitating a more inclusive HIV/AIDS policymaking process in Malawi.

Sie haben noch keine Lizenz? Dann Informieren Sie sich jetzt über unsere Produkte:

Springer Professional "Wirtschaft+Technik"

Online-Abonnement

Mit Springer Professional "Wirtschaft+Technik" erhalten Sie Zugriff auf:

  • über 102.000 Bücher
  • über 537 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Maschinenbau + Werkstoffe
  • Versicherung + Risiko

Jetzt Wissensvorsprung sichern!

Springer Professional "Wirtschaft"

Online-Abonnement

Mit Springer Professional "Wirtschaft" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 340 Zeitschriften

aus folgenden Fachgebieten:

  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Versicherung + Risiko




Jetzt Wissensvorsprung sichern!

Literatur
Zurück zum Zitat Aronson, N. (1984). Science and claims-making activity: Implications for social problems research. In J. W. Schneider & J. I. Kitsuse (Eds.), Studies in the sociology of social problems (pp. 1–30). Norwood, NJ: Ablex. Aronson, N. (1984). Science and claims-making activity: Implications for social problems research. In J. W. Schneider & J. I. Kitsuse (Eds.), Studies in the sociology of social problems (pp. 1–30). Norwood, NJ: Ablex.
Zurück zum Zitat Baker, C. (1975). Government service in Malawi 1891–1974. Journal of History of Medicine, 20(3), 296–311. Baker, C. (1975). Government service in Malawi 1891–1974. Journal of History of Medicine, 20(3), 296–311.
Zurück zum Zitat Berger, P., & Luckman, T. (1980). The social construction of reality. New York: Irvington. Berger, P., & Luckman, T. (1980). The social construction of reality. New York: Irvington.
Zurück zum Zitat Beverwijk, J., Goedegebuure, L., & Huisman, J. (2008). Policy change in nascent subsystems: Mozambican higher education policy 1993–2003. Policy Sciences, 41(4), 357–377.CrossRef Beverwijk, J., Goedegebuure, L., & Huisman, J. (2008). Policy change in nascent subsystems: Mozambican higher education policy 1993–2003. Policy Sciences, 41(4), 357–377.CrossRef
Zurück zum Zitat Bryceson, D., & Fonseca, J. (2006). Risking death for survival: Peasant responses to hunger and HIV/AIDS in Malawi. World Development, 34(8), 1666–2006. Bryceson, D., & Fonseca, J. (2006). Risking death for survival: Peasant responses to hunger and HIV/AIDS in Malawi. World Development, 34(8), 1666–2006.
Zurück zum Zitat Chimbiri, A. (2007). The condom is an ‘intruder’ in marriage: Evidence from rural Malawi. Social Science and Medicine, 64, 1102–1115.CrossRef Chimbiri, A. (2007). The condom is an ‘intruder’ in marriage: Evidence from rural Malawi. Social Science and Medicine, 64, 1102–1115.CrossRef
Zurück zum Zitat Collins, T. (2003). Globalization, global health, and access to healthcare. International Journal of Health Planning and Management, 18, 97–104.CrossRef Collins, T. (2003). Globalization, global health, and access to healthcare. International Journal of Health Planning and Management, 18, 97–104.CrossRef
Zurück zum Zitat de Waal, A., & Whitehead, A. (2003). ‘New Variant Famine’: AIDS and food crisis in Southern Africa. The Lancet, 263, 1234–1237. de Waal, A., & Whitehead, A. (2003). ‘New Variant Famine’: AIDS and food crisis in Southern Africa. The Lancet, 263, 1234–1237.
Zurück zum Zitat Drake, A. (1976). Illness, ritual and social relations among the Chewa of Central Africa. PhD Thesis, Duke University. Drake, A. (1976). Illness, ritual and social relations among the Chewa of Central Africa. PhD Thesis, Duke University.
Zurück zum Zitat Dunn, W. (1981). Public policy analysis. New Jersey: Prentice Hall. Dunn, W. (1981). Public policy analysis. New Jersey: Prentice Hall.
Zurück zum Zitat Englund, H., & Mapanje, J. (2001). Democracy of chameleons; Politics and culture in the New Malawi. Blantyre: CLAIM. Englund, H., & Mapanje, J. (2001). Democracy of chameleons; Politics and culture in the New Malawi. Blantyre: CLAIM.
Zurück zum Zitat Epstein, S. (1996). Impure science: AIDS, activism, and the politics of knowledge. Berkeley and Los Angeles: University of California Press. Epstein, S. (1996). Impure science: AIDS, activism, and the politics of knowledge. Berkeley and Los Angeles: University of California Press.
Zurück zum Zitat Garvin, G., & Eyles, J. (1997). The sun safety metanarrative: Translating science into public health discourse. Policy Sciences, 30, 47–70.CrossRef Garvin, G., & Eyles, J. (1997). The sun safety metanarrative: Translating science into public health discourse. Policy Sciences, 30, 47–70.CrossRef
Zurück zum Zitat Gould, P. (1993). The slow plague: The geography of the AIDS pandemic. Cambridge, MA: Blackwell. Gould, P. (1993). The slow plague: The geography of the AIDS pandemic. Cambridge, MA: Blackwell.
Zurück zum Zitat Graffy, E. (2008). Meeting the challenges of policy-relevant science: Bridging theory and practice. Public Administration Review, 68(6), 1087–1100.CrossRef Graffy, E. (2008). Meeting the challenges of policy-relevant science: Bridging theory and practice. Public Administration Review, 68(6), 1087–1100.CrossRef
Zurück zum Zitat Haraway, D. (1999). Situated knowledges: The science question in feminism and privilege of partial perspective. In J. Agnew, D. Livingstone, & A. Rogers (Eds.), Human geography: An essential anthology (pp. 114–123). Oxford: Blackwell. Haraway, D. (1999). Situated knowledges: The science question in feminism and privilege of partial perspective. In J. Agnew, D. Livingstone, & A. Rogers (Eds.), Human geography: An essential anthology (pp. 114–123). Oxford: Blackwell.
Zurück zum Zitat Harrison, K. (1991). Between science and politics: Assessing the risks of dioxins in Canada and the United States. Policy Sciences, 24, 367–388.CrossRef Harrison, K. (1991). Between science and politics: Assessing the risks of dioxins in Canada and the United States. Policy Sciences, 24, 367–388.CrossRef
Zurück zum Zitat Hearst, N., & Chen, S. (2004). Condom promotion for AIDS prevention in the developing world: Is it working? Studies in Family Planning, 35, 1–2.CrossRef Hearst, N., & Chen, S. (2004). Condom promotion for AIDS prevention in the developing world: Is it working? Studies in Family Planning, 35, 1–2.CrossRef
Zurück zum Zitat Howland, D. (2006). Good press, bad press: A 25-year comparison of arguments and trends in American news coverage of climate change and the ozone hole. Ph. D. Thesis, The University of New Hampshire. Howland, D. (2006). Good press, bad press: A 25-year comparison of arguments and trends in American news coverage of climate change and the ozone hole. Ph. D. Thesis, The University of New Hampshire.
Zurück zum Zitat Howland, D., Larsen, M., & Prelli, J. (2006). Merging content analysis and the policy sciences: A system to discern policy specific trends from news media reports. Policy Sciences, 39, 205–231.CrossRef Howland, D., Larsen, M., & Prelli, J. (2006). Merging content analysis and the policy sciences: A system to discern policy specific trends from news media reports. Policy Sciences, 39, 205–231.CrossRef
Zurück zum Zitat Jasanoff, S. (1987). Contested boundaries in policy-relevant science. Social Studies of Science, 17, 195–230.CrossRef Jasanoff, S. (1987). Contested boundaries in policy-relevant science. Social Studies of Science, 17, 195–230.CrossRef
Zurück zum Zitat Jasanoff, S. (1994). The fifth branch: Science advisers as policymakers. Massachusetts: Harvard University Press. Jasanoff, S. (1994). The fifth branch: Science advisers as policymakers. Massachusetts: Harvard University Press.
Zurück zum Zitat Jasanoff, S. (2007). Technologies of humility, Nature, 33. Jasanoff, S. (2007). Technologies of humility, Nature, 33.
Zurück zum Zitat Kalipeni, E., Craddock, S., Oppong, J., & Ghosh, J. (2004). HIV and AIDS in Africa: Beyond epidemiology. Oxford: Blackwell. Kalipeni, E., Craddock, S., Oppong, J., & Ghosh, J. (2004). HIV and AIDS in Africa: Beyond epidemiology. Oxford: Blackwell.
Zurück zum Zitat Kalipeni, E., & Ghosh, J. (2007). Concern and practice among men about HIV/AIDS in low socioeconomic income areas of Lilongwe, Malawi. Social Science and Medicine, 64, 1116–1127.CrossRef Kalipeni, E., & Ghosh, J. (2007). Concern and practice among men about HIV/AIDS in low socioeconomic income areas of Lilongwe, Malawi. Social Science and Medicine, 64, 1116–1127.CrossRef
Zurück zum Zitat Krippendorff, K. (1980). Content analysis: An introduction to its methodology. California: Sage. Krippendorff, K. (1980). Content analysis: An introduction to its methodology. California: Sage.
Zurück zum Zitat Kuhn, T. (1962). The structure of scientific revolution. Chicago: University of Chicago Press. Kuhn, T. (1962). The structure of scientific revolution. Chicago: University of Chicago Press.
Zurück zum Zitat Lasswell, H. D. (1971). A pre-view of the policy sciences. New York: American Elsevier. Lasswell, H. D. (1971). A pre-view of the policy sciences. New York: American Elsevier.
Zurück zum Zitat Leach, M., Scoones, I., & Wynne, B. (2005). Introduction: Science, citizenship and globalization. In M. Leach, I. Scoones, & B. Wynne (Eds.), Science and citizens: Globalization and the challenge of engagement (pp. 3–14). London: Zed Books. Leach, M., Scoones, I., & Wynne, B. (2005). Introduction: Science, citizenship and globalization. In M. Leach, I. Scoones, & B. Wynne (Eds.), Science and citizens: Globalization and the challenge of engagement (pp. 3–14). London: Zed Books.
Zurück zum Zitat Lubchenco, J. (1998). Entering the century of the environment: A new social contract for science. Science, 279, 491–497.CrossRef Lubchenco, J. (1998). Entering the century of the environment: A new social contract for science. Science, 279, 491–497.CrossRef
Zurück zum Zitat Luginaah, I., Yiridoe, E., & Taabazuing, M. (2005). From mandatory to voluntary testing: Balancing human rights, religious and cultural values, and HIV prevention in Ghana. Social Science and Medicine, 61(8), 1689–1700.CrossRef Luginaah, I., Yiridoe, E., & Taabazuing, M. (2005). From mandatory to voluntary testing: Balancing human rights, religious and cultural values, and HIV prevention in Ghana. Social Science and Medicine, 61(8), 1689–1700.CrossRef
Zurück zum Zitat Lwanda, J. (1993). Kamuzu Banda of Malawi. Glasgow: Dudu Nsomba Publications. Lwanda, J. (1993). Kamuzu Banda of Malawi. Glasgow: Dudu Nsomba Publications.
Zurück zum Zitat Lwanda, J. (2002). Politics, culture and medicine in Malawi: Historical continuities and ruptures with special reference to HIV/AIDS. PhD Thesis, University of Glasgow. Lwanda, J. (2002). Politics, culture and medicine in Malawi: Historical continuities and ruptures with special reference to HIV/AIDS. PhD Thesis, University of Glasgow.
Zurück zum Zitat Malawi Government. (2002). Malawi poverty reduction strategy. Lilongwe: Malawi Government. Malawi Government. (2002). Malawi poverty reduction strategy. Lilongwe: Malawi Government.
Zurück zum Zitat Malawi Government. (2003). Malawi HIV/AIDS policy. Lilongwe: Malawi Government. Malawi Government. (2003). Malawi HIV/AIDS policy. Lilongwe: Malawi Government.
Zurück zum Zitat Mandala, E. (1990). Work and control in a peasant economy: History of lower Tchiri Valley in Malawi, 1859-1960. Madison: University of Wisconsin Press. Mandala, E. (1990). Work and control in a peasant economy: History of lower Tchiri Valley in Malawi, 1859-1960. Madison: University of Wisconsin Press.
Zurück zum Zitat Maurizio, M., Kelaghan, J., Lynn, A., Harland, A., Michael, F., Edward, H., et al. (1999). Mechanical failure of latex condoms in a cohort of women at high STD risk. Journal of American Sexually Transmitted Diseases, 26(8), 450–458.CrossRef Maurizio, M., Kelaghan, J., Lynn, A., Harland, A., Michael, F., Edward, H., et al. (1999). Mechanical failure of latex condoms in a cohort of women at high STD risk. Journal of American Sexually Transmitted Diseases, 26(8), 450–458.CrossRef
Zurück zum Zitat Moore, A., & Oppong, J. (2007). Sexual risky behavior among people living with HIV/AIDS in Togo. Social Science and Medicine, 64, 1057–1066.CrossRef Moore, A., & Oppong, J. (2007). Sexual risky behavior among people living with HIV/AIDS in Togo. Social Science and Medicine, 64, 1057–1066.CrossRef
Zurück zum Zitat Moto, F. (2004). Towards a study of the lexicon of sex and HIV/AIDS. Nordic Journal of African Studies, 13(3), 343–362. Moto, F. (2004). Towards a study of the lexicon of sex and HIV/AIDS. Nordic Journal of African Studies, 13(3), 343–362.
Zurück zum Zitat Neuendorf, K. A. (2002). The content analysis guidebook. Thousand Oaks, CA: Sage. Neuendorf, K. A. (2002). The content analysis guidebook. Thousand Oaks, CA: Sage.
Zurück zum Zitat Neuman, W. L. (2006). Basics of social research: Qualitative and quantitative approaches. London: Person. Neuman, W. L. (2006). Basics of social research: Qualitative and quantitative approaches. London: Person.
Zurück zum Zitat O’Brien, M. (1981). The politics of representation. Boston: Routledge and Keegan Paul. O’Brien, M. (1981). The politics of representation. Boston: Routledge and Keegan Paul.
Zurück zum Zitat Ozawa, C., & Susskind, L. (1985). Mediating science-intensive disputes. Journal of Policy Analysis and Management, 5(1), 23–39.CrossRef Ozawa, C., & Susskind, L. (1985). Mediating science-intensive disputes. Journal of Policy Analysis and Management, 5(1), 23–39.CrossRef
Zurück zum Zitat Peltzer, K. (1987). Some contributions of traditional healing practices towards psychosocial healthcare in Malawi, Eschborn b. Frankfurt a.M. Peltzer, K. (1987). Some contributions of traditional healing practices towards psychosocial healthcare in Malawi, Eschborn b. Frankfurt a.M.
Zurück zum Zitat Phoebe, K., Kamya, M., Kamya, S., Chen, S., McFarland, W., & Hearst, N. (2005). Increasing condom use without reducing HIV risk: Results of a controlled community trial in Uganda. Journal of Acquired Immune Deficiency Syndromes, 40(1), 77–82.CrossRef Phoebe, K., Kamya, M., Kamya, S., Chen, S., McFarland, W., & Hearst, N. (2005). Increasing condom use without reducing HIV risk: Results of a controlled community trial in Uganda. Journal of Acquired Immune Deficiency Syndromes, 40(1), 77–82.CrossRef
Zurück zum Zitat Popper, K. (1989). Objective knowledge: An evolutionary approach. Oxford: Clarendon. Popper, K. (1989). Objective knowledge: An evolutionary approach. Oxford: Clarendon.
Zurück zum Zitat Roe, E. (1994). Narrative policy analysis: Theory and practice. Durham and London: Duke University Press. Roe, E. (1994). Narrative policy analysis: Theory and practice. Durham and London: Duke University Press.
Zurück zum Zitat Rushefsky, M. (1986). Making cancer policy. New York: SUNY Press. Rushefsky, M. (1986). Making cancer policy. New York: SUNY Press.
Zurück zum Zitat Sabatier, P. A. (1987). An advocacy coalition framework of policy change and role of policy-oriented learning therein. Policy Sciences, 21, 129–168.CrossRef Sabatier, P. A. (1987). An advocacy coalition framework of policy change and role of policy-oriented learning therein. Policy Sciences, 21, 129–168.CrossRef
Zurück zum Zitat Sarewitz, D., & Pielke, R. (1999). Prediction in science and policy. Technology in Society, 21, 121–133.CrossRef Sarewitz, D., & Pielke, R. (1999). Prediction in science and policy. Technology in Society, 21, 121–133.CrossRef
Zurück zum Zitat Schneider, H. (2002). On the fault-line: The politics of AIDS in policy in contemporary South Africa. African Studies, 6(1), 145–167.CrossRef Schneider, H. (2002). On the fault-line: The politics of AIDS in policy in contemporary South Africa. African Studies, 6(1), 145–167.CrossRef
Zurück zum Zitat Schoffeleers, J. (1999). The AIDS pandemic, the Prophet Billy Chinsupe and the democratization process in Malawi. Journal of Religion in Africa, 29(4), 406–441.CrossRef Schoffeleers, J. (1999). The AIDS pandemic, the Prophet Billy Chinsupe and the democratization process in Malawi. Journal of Religion in Africa, 29(4), 406–441.CrossRef
Zurück zum Zitat Sprague, J., & Zimmerman, M. (2004). Overcoming dualisms: A feminist agenda for sociological methodology. In S. Hesse-Biber & P. Leavy (Eds.), Approaches to qualitative research: A reader on theory and practice (pp. 39–59). New York: Oxford University Press. Sprague, J., & Zimmerman, M. (2004). Overcoming dualisms: A feminist agenda for sociological methodology. In S. Hesse-Biber & P. Leavy (Eds.), Approaches to qualitative research: A reader on theory and practice (pp. 39–59). New York: Oxford University Press.
Zurück zum Zitat Stone, J., Vittinghoff, E., Douglas, J., Mayer, H., Celum, L., Gross, M., et al. (1999). Correlates of condom failure in a sexually active cohort of men who have sex with men. Journal of Acquired Immune Deficiency Syndrome, 20(5), 495–501. Stone, J., Vittinghoff, E., Douglas, J., Mayer, H., Celum, L., Gross, M., et al. (1999). Correlates of condom failure in a sexually active cohort of men who have sex with men. Journal of Acquired Immune Deficiency Syndrome, 20(5), 495–501.
Zurück zum Zitat Torgerson, D. (1986). Between knowledge and politics: Three faces of policy analysis. Policy Sciences, 19, 33–59.CrossRef Torgerson, D. (1986). Between knowledge and politics: Three faces of policy analysis. Policy Sciences, 19, 33–59.CrossRef
Zurück zum Zitat UNIAIDS (2008). Report on the global AIDS epidemic. Geneva: UNAIDS. UNIAIDS (2008). Report on the global AIDS epidemic. Geneva: UNAIDS.
Zurück zum Zitat U.S. General Accounting Office (1996). Content analysis: A methodology for structuring and analyzing written material. Washington, D.C. U.S. General Accounting Office (1996). Content analysis: A methodology for structuring and analyzing written material. Washington, D.C.
Zurück zum Zitat van den Hove, S. (2007). A rationale for science-policy interfaces. Futures, 39, 807–826.CrossRef van den Hove, S. (2007). A rationale for science-policy interfaces. Futures, 39, 807–826.CrossRef
Zurück zum Zitat Weller, S., & Davis, K. (2003). Condom effectiveness in reducing HIV transmission, The Cochrane Library, Issue 2. Oxford: Update Software. Weller, S., & Davis, K. (2003). Condom effectiveness in reducing HIV transmission, The Cochrane Library, Issue 2. Oxford: Update Software.
Zurück zum Zitat Woodward, G., & Denton, R. (2000). Persuasion and influence in American life. Illinois: Waveland Press. Woodward, G., & Denton, R. (2000). Persuasion and influence in American life. Illinois: Waveland Press.
Zurück zum Zitat World Development Movement (2002). Structural damage: The causes and consequences of Malawi food crisis report: London. World Development Movement (2002). Structural damage: The causes and consequences of Malawi food crisis report: London.
Zurück zum Zitat Wynne, B. (1984). The institutional context of science, models, and policy: The IIASA energy study. Policy Sciences, 17(3), 277–320.CrossRef Wynne, B. (1984). The institutional context of science, models, and policy: The IIASA energy study. Policy Sciences, 17(3), 277–320.CrossRef
Metadaten
Titel
Deadly divide: Malawi’s policy debate on HIV/AIDS and condoms
verfasst von
Paul Mkandawire
Isaac N. Luginaah
Rachel Bezner-Kerr
Publikationsdatum
01.03.2011
Verlag
Springer US
Erschienen in
Policy Sciences / Ausgabe 1/2011
Print ISSN: 0032-2687
Elektronische ISSN: 1573-0891
DOI
https://doi.org/10.1007/s11077-010-9111-5

Weitere Artikel der Ausgabe 1/2011

Policy Sciences 1/2011 Zur Ausgabe

Premium Partner