Comparing Policies, Politics & Disease: The HIV Policy Lab

• In Event: Deepening Global Health Politics: Policies, Agendas, and Democratic Complexity

Abstract

Health policies differ substantially between countries and within countries over time—with significant heterogeneity in the speed and shape of change between countries and within specific policy areas. This variation has provided grounds for study of policy processes (e.g. diffusion, learning), the effect of institutions on policy environments (e.g. electoral systems, ethnic boundaries), and for evaluating the public health impact of policies. Systematic study of the drivers and results of this variation, however, has often been hampered by limited information about the policy environment—particularly for low- and middle-income countries. Here we describe a new project called the HIV Policy Lab and a dataset that tracks the adoption of HIV-related policies across 32 different dimensions in over 180 countries across three years. These dimensions include a wide range of policies—from HIV treatment policies, such as the clinical standard of care, to criminal laws on consensual same-sex acts to policies related to intellectual property and medicines. Policy information was collected through examination of primary documents as well as a set of surveys of national government officials and policy experts, with information coded for comparison to norms set forth by international agreements and health agencies. An initial summary index score was developed to allow comparison. This paper describes initial findings on the variation in policies across dimensions, between countries, and over time. We explain the nature of the data-collection and -structuring efforts and we suggest some ways this new infrastructure could allow new types of comparative analyses of public policy, institutions, and health outcomes. We encourage political scientists to incorporate measures of the policy environment as both dependent and independent variables, where institutional and electoral explanations have previously dominated, and as context for qualitative analysis.

Authors

• Matthew Kavanagh, Georgetown University

• Mara Pillinger, Georgetown University