Beyond HIV/AIDS: Has The President's Emergency Plan for AIDS Relief Sparked Policy Change?

This paper examines the President’s Emergency Plan for AIDS Relief’s (PEPFAR) effect on national policy change in fifteen recipient countries. It looks at three policies across these countries: abstinence, be faithful, use condoms; anti-prostitution pledge; and men who have sex with men. Countries are most likely to make a policy change when the policy is explicitly stated in PEPFAR and implemented by the national government. In Uganda, strong leadership by President Museveni led to policy change toward American preferences, despite an existing and successful national HIV/AIDS plan. In Kenya, the newly elected President Kibaki implemented PEPFAR policy priorities and used the ensuing funding to establish himself as a leader in the fight against HIV/AIDS. In both cases, the countries shifted towards American preferences because the policies in question were implemented on a national level and explicitly required by PEPFAR.