Germs and Governments: Politics of HIV/AIDS in Developing Democracies Open Access
Kakietek, Jakub (2011)
Published
Abstract
Abstract
Germs and Governments: Electoral Market Imperfections and the
Politics of HIV/AIDS
in Developing Democracies.
By Jakub Kakietek
Although well established theories in the scholarship on political
economy and social
policy suggest a link between democratic regimes and high quality
of social policy, a
closer look at the Caribbean suggests otherwise. In particular, it
reveals considerable
variation in the way developing democratic nations in the region
responded to the
epidemic. My dissertation addresses this puzzle by exploring the
reasons similarly
democratic countries can produce dramatically different policy
outcomes. It attempts to
answer two questions pertaining to the impact of democratic
accountability of
HIV/AIDS policy: 1) under what conditions institutions of
democratic representation
improve HIV/AIDS policy outcomes and 2) is the impact of democracy
the same for
policies affecting the general population (e.g. providing
prophylaxis for the prevention of
mother-to-child transmission (PMTCT) of HIV ) and policies
affecting marginalized
groups: men who have sex with men and commercial sex workers.
I argue that imperfections in electoral
markets mediate the impact of democratic institutions on policy,
including measures
aimed at fighting HIV/AIDS. More specifically, imperfections in
the electoral markets,
defined as: 1) lack of access to
information among the citizens, 2) ethnic polarization,
and, 3) limited trust of the citizens in politicians, in particular
the lack of trust that
politicians deliver on their electoral promises, suppress the
positive impact of democratic
accountability and lead to HIV/AIDS policy failures in democratic
countries. In countries
where electoral market imperfections are more pronounced, policies
and institutions
aimed at fighting AIDS take longer to develop, spending on AIDS and
the availability of
services for those infected and at risk are low, and the effects of
the efforts to fight AIDS,
such as behavioral change in those at risk of infection, are
limited.
Germs and Governments: Electoral Market Imperfections and the
Politics of HIV/AIDS
in Developing Democracies.
By
Jakub Kakietek
Master of Arts, 2001, Emory University, 2003
Master of Public Health, Rollins School of Public Health,
2009
Advisor: Richard Doner, Ph.d.
A dissertation submitted to the Faculty of the
James T. Laney School of Graduate Studies of Emory University
in partial fulfillment of the requirements for the degree of Doctor
of Philosophy in
Political Science
2011
Table of Contents
Table of Contents:
CHAPTER 1: INTRODUCTION
..............................................................................p.
1
CHAPTER 2: QUANTITATIVE
ANALSYSIS........................................................p.
36
CHAPTER 3: BARBADOS CASE STUDY
.............................................................p.
83
CHAPTER 4: TRINIDAD AND TOBAGO CASE STUDY
.................................p. 147
CHAPTER 5: ELECTORAL MARKET IMPERFECTIONS
AND SOCIALLY MARGINALIZED GROUPS - THE
CASE OF THE WALROND REPORT
...................................................p. 201
CHAPTER 6: CONCLUSIONS
..........................................................................p.
223
APPENDIX A: IN-DEPTH INTERVIEW SECTORS AND
DATES....................................p.
About this Dissertation
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