Governmental national AIDS programs.

This chapter in a book on the global dimensions social roots and responses to AIDS in the world presents and discusses data gleaned from the most extensive survey of governmental national AIDS programs (GNAPs) to date. This discussion is organized according to the framework of 11 criteria which was used to develop the survey instrument. It was found that 60% of high government officials have voiced a commitment to combat AIDS. This commitment was translated into action by the founding of GNAPs in essentially all countries by 1994. While 85% of responding countries had created a national AIDS advisory committee in an attempt at coalition building only 18% of countries consulted all pertinent groups in AIDS policy development. Planning and coordination have taken the form of development of an AIDS policy and program document in 82% of the 118 responding countries but most GNAPs are identified with ministries of health rather than with a broader mandate. Management was measured by levels of GNAP training which were found to be low and by program decentralization which occurred wholly or partially in 77% of the countries. Prevention and care activities were indicated by condom distribution (allowed in some but not all logical sites) and in availability of voluntary testing and counseling which is not uniform. Developing countries mobilized more than 80% of the costs of AIDS programs internally which bodes well for sustainability. Most countries evaluated their GNAP at least once and over half improved their programs as a result.