摘要：

The paper shows how policies aimed at confronting HIV/AIDS in sub-Saharan Africa have shifted over the past 10 years. Initially, the focus was on prevention. Anti-retroviral treatments (ARVs), which could prolong the lives of people living with HIV and AIDS, were considered too expensive for the African poor. In 2000, following global campaigns to lower the prices of ARVs, and concern about the political instability caused by AIDS in Africa, policies started focusing on access to treatment. Cost-effectiveness arguments played a key role in the formulation and implementation of the prevention policies, while human rights and equity considerations drive the current treatment programmes. Though different in policy content, the prevention and treatment policies have in common that they pay little attention to the socio-cultural realities in sub-Saharan Africa that ultimately determine their success. Based on illustrative case material from Uganda, the paper calls for more research on and understanding of the successes and failures of prevention and treatment programmes. Such understanding can help adapt global policies to local realities.

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