@article{014fb19f13cb451d89161e95988a98ee,
title = "Boundary institutions and HIV/AIDS policy in Brazil and South Africa",
abstract = "Why have some national governments acted more aggressively to address the HIV/AIDS pandemic than others? More specifically, what explains widely varied responses across Brazil and South Africa - two countries where one might have expected more similarity than difference? We argue that boundary institutions - those sets of rules and practices that give social and political meaning to group identities - help explain this puzzle. Institutions interact with other pressures to structure the dissemination of information, the construction of risk, and priorities within society. Where institutions divide groups deeply, elites and ordinary citizens are less likely to feel vulnerable, and more likely to blame other groups, making aggresive government action far less likely.",
author = "Varun Gauri and Lieberman, {Evan S.}",
note = "Funding Information: We gratefully acknowledge fine research assistance from Christina Shim and Nalim Gupta, and helpful comments from Catherine Boone, Chris Beyrer, John Getting, Denise Vaillancourt, Martha Ainsworth, Nancy Bermeo, Deborah Yashar; attendees of presentations at Princeton, Berkeley, Stanford, Harvard, Georgetown, Brow n, the University of Pennsylvania, and at the World Bank: and the editors of SCID and the anonymous reviewers. We also thank the dozens of South Africans and BraTllians who shared valuable informanon and their professional insights ill intervmws conducted by the authors. This paper ~ as originally presented at the Annual Meetings of the American Political Science Assocmtion, Chicago, IL, 2-5 September 2004. Ewm Lieber-man gratefully acknowledges financial support for his research from the Robert Wood Johnson Foundation and the Yale Umversity's Center for Interdisciphnary Research on AIDS (CIRA). The views expressed m this paper do not necessarily leflect those of the World Bank or its executive directors. A review of the contents of the leading political science journals identified no pubhshed articles on AIDS outside the United States, and only a handful of articles on AIDS in the United States. In African studies journals, Boone and Batsell (2001) and Hyden and Lanegran (1996) called for greater attentmn to the need for pohtical scmnce research on the issue, but only very recently are scholars beginning to apply theoretical and empirical tools to th~s problem In the amcle, we make sparing reference to these interviews because in most cases, we agreed to anonymity, and because our sources related to us more general trends and dynamics in pohtlcs and policymaking. We have preferred to document more specific outcomes and rhetoric through pubhcly available sources, but our interview notes support the narrahves presented in the text. This is less true flw treatment and care policies, but these have been available only much later m the history of the epidemic, and stigma and discnmmatmn remain obstacles in efforts to locate and support mdiwduals who need treatment. Like Nathanson (1996), we build on longstanding sociological conclusions that risk is socmlly constructed (Douglas and Wildavsky, 1983, Clarke and Short, 1993). See, for example, Varshney (2002) and Lamont and Moln~ir (2002) for discussions of how non-state and informal mstitumms may reinforce or break down such boundaries. Other comparative analyses of Brazil and South Africa include Heller (2001): Seidman ( 1994): Marx ( 19981: Lleberman (2003). See Okie (2006), fl)r a more detailed discussion of the Brazilian policy response from a biomedical perspective. At the time of writing, some 200,000 to 230,000 South Africans with H1V were receiving AIDS treatment, about half in the public and hall in the private sectors. The numbers currently treated are not inthcative of the overall govermnenl response. Brazil treated more people sooner, and at a",
year = "2006",
month = sep,
doi = "10.1007/BF02686236",
language = "English (US)",
volume = "41",
pages = "47--73",
journal = "Studies in Comparative International Development",
issn = "0039-3606",
publisher = "Springer New York",
number = "3",
}