Both trade and climate change policies affect the international competitiveness of carbon-intensive industries. This suggests that policy changes in one area may affect politics in the other. Does openness to international trade affect climate change politics? Do climate change policies affect the politics of trade? Does formally linking trade and climate policies via trade sanctions affect the prospects for cooperation in each domain? There are good theoretical reasons to believe that the answer to these questions is yes. Theoretically, each set of policies should affect the other, but these interactions could either encourage or discourage trade and climate cooperation. How trade and climate politics interact is thus an empirical question. Empirically, the overall picture is of a nascent but promising field of research. Extant studies provide indirect tests and suggestive evidence, but little in the way of firm conclusions. Only one point emerges clearly: progress in this area will require more and better data on national climate policies.
The Politics of Trade and Climate Change
Daniel Yuichi Kono
Environmental Policy and Foreign Policy
International agreements on environmental issues are the result of the coordination of states’ foreign policies. To understand the international politics of the environment requires attention to the institutional, social, economic, and cognitive factors that determine foreign policies. Although nearly every foreign policy bears on environmental concerns, the focus is on the policies that states adopt centered on humanity’s relationship to the natural world and ecology. Scholarship on environmental policy and foreign policy has not developed distinctive schools of thought. However, organizing scholarship according to a theoretically grounded typology reveals affinities among various scholarly works: systemic, societal, and state-centric approaches can be grouped according to whether they emphasize power, interests, or cognitive factors. Most studies of environmental foreign policy are oriented toward problem solving—identifying discrete problems in existing institutional arrangements and pointing toward solutions to these problems that do not question the institutions fundamentally. This orientation may not be adequate if crossing planetary boundaries leads to environmental challenges so severe that current institutions cannot cope. Climate change poses just such a challenge, and the rising concentration of greenhouse gases in the atmosphere means a future crisis is predictable. Thus, scholars might be best advised to orient toward critical theory, which seeks feasible alternatives to existing arrangements. The study of foreign policy toward the environment would be most useful in helping scholars and policy makers to identify and surmount barriers to transformational changes that would enable humanity to cope with future environmental crisis.
Global (Distributive) Justice
Most philosophers agree that it is unjust for one’s life prospects to be determined by one’s race, gender, or social class. And most think that there are demanding duties on members of the same political community (co-citizens) to reduce inequalities that track these features of individuals. But philosophers strongly disagree about how to evaluate inequalities that track the country one is born in. Are global inequalities (inequalities among individuals living in different countries) as problematic and for the same reasons as domestic inequalities (inequalities among co-citizens)? The question of whether egalitarian principles of distributive justice extend globally, beyond the domestic sphere, has been the central question in the debate on global distributive justice. Statists argue that there is something normatively significant about the state, but not the global institutional order, which grounds one’s concerns with domestic inequalities, but not global inequalities. Global egalitarians argue that global inequalities are as unjust to the same extent and for the same reasons as domestic inequalities. The disagreement between both camps can be traced back to different normative, empirical, and methodological assumptions. Statists and global egalitarians can, however, converge on a number of important issues, and the debate can be advanced beyond the stalemate it has reached by investigating these issues of convergence. Significantly, statists can agree with global egalitarians that global justice requires equality of concern (the requirement that interests of all individuals have equal weight), and global egalitarians have reasons to take states seriously to the extent that having a world of states (or multiple political communities) can be shown to be compatible with the requirement of equal concern. Thus, it is important to work out whether individuals have a fundamental interest in being members of political communities, how that interest compares to their interests in opportunities, income, and wealth, and which institutional arraignments can advance these interests according to the right balance.
Transnational Administration of Regional and Global Policies
Kim Moloney and Diane Stone
Transnational administration is the routinization and bureaucratization of global governance. Concepts of transnational administration move beyond methodological nationalism and absolutist understandings of administrative sovereignty vested solely with nation-state authorities to articulate various administrative arenas of global policy. Transnational administration is a new “third scale” of public administration. The first two scales of public administration are national administration, and its internationalization due to globalization, and the international public administration located in the secretariats of international organizations. Transnational administration incorporates nonstate actors in decentralized, devolved, or delegated interactions within and between policy communities operating in global and regional spheres. Organizations such as the Bank of International Settlements, the Kimberley Process, the Global Health and Partnership Model, and Transparency International highlight the actions of transnational administrative actors. Critiques of these and other organizations have raised new concerns about accountability, representation, and transparency.
Global Governance in Foreign Policy
Global governance is a story of human agency confronting the existential challenge of the seismic shift in the international system that is called globalization. Neither phenomenon is yet understood sufficiently in academic theory, but if any social scientific practice is best situated to research it to the requisite depth, it is the discipline of foreign policy analysis. The theory and practice of foreign policy making and implementation are bound to undergo a transformation as radical as the international system. This historic process is dissolving the structure of agency that was set by the Treaty of Westphalia in 1648. The result has been for state and nonstate actors to compensate with a motley assemblage of structural improvisations, which have been complicating international relations, adding multiple levels of agency above and below the classical nation-state. Where this development will ultimately lead is unknown.
Climate Change and Justice
Understanding the complex set of processes collected under the heading of climate change represents a considerable scientific challenge. But it also raises important challenges for our best moral theories. For instance, in assessing the risks that climate change poses, we face profound questions about how to weigh the respective harms it may inflict on current and future generations, as well as on humans and other species. We also face difficult questions about how to act in conditions of uncertainty, in which at least some of the consequences of climate change—and of various human interventions to adapt to or mitigate it—are difficult to predict fully. Even if we agree that mitigating climate change is morally required, there is room for disagreement about the precise extent to which it ought to be mitigated (insofar as there is room for underlying disagreement about the level of temperature rises that are morally permissible). Finally, once we determine which actions to take to reduce or avoid climate change, we face the normative question of who ought to bear the costs of those actions, as well as the costs associated with any climate change that nevertheless comes to pass.
Labor and Trade Protection in Comparative Perspective
Erica Owen and Rena Sung
Research on the domestic politics of trade typically begins with a theory about who benefits from trade and who is harmed by it. The actors—for instance, firms, workers, or industries—who benefit from trade are expected to support liberalization while those who are harmed are expected to oppose liberalization. For individuals, exposure to globalization through the labor market—including the type of job, firm, or industry—is likely to be an important determinant of individuals’ preferences over policies governing the global economy. To understand the domestic politics of trade with respect to labor, therefore, it is important to ask two key questions. First, what explains the preferences of workers? Broadly, scholars can be divided between those that argue different economic factors (i.e., labor market consequences) explain attitudes toward free trade and those who argue that noneconomic factors (e.g., values, information) are the main drivers of attitudes. Empirical tests of these theories rely on survey data. Second, how do trade pressures influence elections and when do workers’ interests influence policy outcomes? Research on mass politics shows that workers’ interests with respect to trade shape not only support for incumbents in elections but also whether elected officials support free trade. Domestic institutions also play an important role in this process, with research suggesting that democracies and left-leaning governments implement trade policies that are more favorable to workers. Yet trade in the 21st century looks very different from trade 30 years ago. It no longer involves only (or even primarily) the exchange of final goods but also trade in intermediate goods and services. Trade is also closely linked to the production strategies of multinational firms, including offshoring. These fundamental changes in the nature of global economic activity have important implications for the how the interests of workers relate to those of their employers, and by extension the politics of trade. As a result, scholars are increasingly incorporating new models of trade into analysis of politics at the individual and aggregate levels.
Systemic Causes of Civil Wars
Civil wars in the contemporary world are deeply interpenetrated by international influences. There are six different conceptions of the international system and their effects on civil conflicts: (1) the realist conception and the superpower interventions of the Cold War period, (2) the liberal institutional conception and the diplomatic mediation of the United Nations, (3) global cultural influences such as world religions, democratization and education, (4) the global economy and structural poverty, (5) transnational bilateral relations with neighboring states, and (6) the planetary ecosystem and the effects of climate change. Taken together, these international influences have a weighty effect on the conduct and duration of contemporary civil wars.
Infectious Disease as a Foreign Policy Threat
Rebecca Katz, Erin Sorrell, and Claire Standley
The last 30 years have seen the global consequences of newly emerging and re-emerging infectious diseases, starting with the international spread of HIV/AIDS, the emergence of Ebola and other hemorrhagic fevers, SARS, MERS, novel influenza viruses, and most recently, the global spread of Zika. The impact of tuberculosis, malaria, and neglected tropical diseases on society are now better understood, including how these diseases influence the social, economic, and political environment in a nation. Despite international treaties and norms, the specter of intentional use of infectious disease remains present, particularly as technological barriers to access are reduced. The reality is that infectious diseases not only impact population health, but also have clear consequences for international security and foreign policy. Foreign policy has been used to coordinate response to infectious disease events and to advance population health around the world. Conversely, collaboration on infectious disease prevention, preparedness, and response has been used strategically by nations to advance diplomacy and improve foreign relations. Both approaches have become integral to foreign policy, and this chapter provides examples to elucidate how health and foreign policy have become intertwined and used with different levels of effectiveness by governments around the world. As the scope of this topic is extensive, this article primarily draws from U.S. examples for brevity’s sake, while acknowledging the truly global nature of the dynamic between infectious diseases and foreign policy, and noting that the interplay between them will vary between countries and regions. In 2014, U.S. President Barak Obama called upon global partners to, “change our mindsets and start thinking about biological threats as the security threats that they are—in addition to being humanitarian threats and economic threats. We have to bring the same level of commitment and focus to these challenges as we do when meeting around more traditional security issues”. With world leaders increasingly identifying disease as threats to security and economic stability, we are observing infectious diseases—like no other time in history—becoming an integral component of foreign policy.
The Globalization of Protest in Africa
Academic studies on the globalized dimension of African protests have complexified the understanding of “transnational social movements,” too often considered as the mechanical and adequate response to a newly globalized neoliberal economy. The long history of globalized protest in and about Africa, starting from the antislavery campaigns to the global justice movements, shows that these movements, often initiated outside the continent, have contributed to the “invention of Africa.” The notion of “extraversion” developed by Jean-François Bayart to explain African states’ relation to the outside world helps interrogating the material and symbolic asymmetrical relationships inside these networks but also the agency of African protesters in shaping their causes. Resources, legitimate knowledge, and audiences of protest are structurally located with Western actors, creating misunderstanding or conflicts in these globalized networks. But African activists do benefit from their internationalization, acting as a protection and a—sometimes contested—legitimation. Also, against the imposition of supposedly universal causes, African protesters have developed new concepts and narratives, especially on gender and sex rights, to assert an African way of framing these causes. Far from being completely constrained by Western agenda, funding, or audience, some local conflicts also benefit from often international ramifications born out of the development of transnational criminal economies. Lastly, reflections on the regional variations and the diffusion of protest inside the continent shows a differential density of international networks and the growing importance of social media in the globalization of protest.
The Comparative and International Political Economy of Anti-Globalization Populism
Robert J. Franzese
The basic economics of international trade imply that globalization will have driven in the developed democracies of the Western world an increasing divergence between the material advancement of human, physical, and financial capitalists—a minority of the population—and the material stagnation or even decline of labor—a majority. This article reviews that theory and the strong comparative-historical empirical record substantiating those effects, and explains how the rise of xenophobic, nationalistic, anti-elite populism has its complementary roots in these economic developments.
Religion in Foreign Policy
Most states’ foreign policies are secular in orientation and focus. A few make religion a prominent component of their ideological approach to foreign policy. States whose foreign policies are consistently or irregularly informed by religion include Egypt, Iran, India, Israel, Saudi Arabia, and the United States. In each case, these states’ foreign policies feature domestic religious actors seeking to have regular or intermittent involvement in foreign policymaking. The impact and capacity of such religious actors is linked to the ideological and/or national interest priorities of incumbent governments. That is, religious actors may have an input into foreign policymaking, which reflects a concern more generally with the association between material concerns—including national security issues—and religious and ethical ideas, norms, and values. In addition to states with input from religious actors in foreign policymaking, there are several important nonstate actors whose religious beliefs centrally inform their foreign policies, which often focus on activities in the United Nations, the world’s largest and most comprehensive organization with near-universal state membership. The United Nations is a key focal point to pursue such policies, and three such actors are discussed: the Holy See/Vatican (and, more generally, the Roman Catholic Church), the Organisation of Islamic Cooperation (OIC), and the World Council of Churches (WCC), whose religious orientations are, respectively, Roman Catholicism, Islam, and non-Catholic Christianity. The importance of religious actors in foreign policy, in relation to both selected states and nonstate actors, is explored.
Populism in Foreign Policy
The topic of populism in foreign policy is receiving growing attention in academic and public discourse as populist parties and movements proliferate around the world. Yet foreign policy analysis (FPA) scholars interested in the role of populism in foreign policy have to deal with a concept that is notoriously slippery and contested. The existing literature on populism and foreign policy has already offered interesting insights. Focused primarily on Europe, it usually applies the conceptualization of populism as a thin-centered ideology that attaches to thicker ideological traditions and reformulates them in terms of the elite-people divide. Following this conceptualization (that is today the dominant framework for the comparative analysis of populism, particularly in Europe), this literature argues that populist parties of the right have foreign policy positions that reflect their nativism, opposition to immigration, focus on national sovereignty, and rejection of economic and cultural globalization. Populist parties of the left on the other hand reject in their foreign policy positions neo-liberalism and open markets. Together, European populist parties of all persuasions are Eurosceptic, anti-American, and usually pro-Putin’s Russia. Highlighted are the breadth of critical and discursive approaches on populism that scholars of populism and foreign policy can use, particularly because they have been applied successfully to cases outside of Europe, where populists have long held political power and have influenced foreign policy in practice. Such conceptualizations commonly view populism as a reaction to crises of political representation engendered by dislocations caused by globalization and other shifts in international politics. These dislocations will take different forms, but populism in the West and populism in the Global South can be seen, despite more specific differences of outlook, at the very least as a specific type of reaction to concurrent political and economic crises in a rapidly denationalized and deterritorialized world. In this context, most populist foreign policies reflect a preoccupation with popular sovereignty and unmediated projection of popular demands and national interests outside of established processes of global governance. Populists will also tend to perceive and analyze foreign policy issues through the lens of the elite-underdog opposition. Populism is commonly associated or conflated with nationalism (especially in the case of the European radical right) and isolationism, but in practice this does not always have to be the case. The “people” for whom populists speak in international affairs can very well transcend national borders, as evidenced, for example, in the foreign policies of Hugo Chavez and Mahmud Ahmadinejad, who aimed to represent transnational constituencies like the Global South, the Islamic world, the world poor, etc. And while populists generally eschew commitments to broader milieu goals of the international system, they can still engage with foreign affairs if they see immediate material benefits. The same goes for trade: populists (particularly in the United States) are seen usually as ideological protectionists, but most often they do not mind striking trade deals if these favor their interests (see, e.g., Donald Trump’s discourse on this issue). In terms of theoretical and methodological advancements, foreign policy scholars interested in populism are urged to embrace the large variety of conceptual approaches on populism (ideological, critical, discursive) and to build on the growing literature on cross-regional comparison of populist politics, something particularly pertinent in a world characterized by the presence and prominence of populism in almost all world regions.
Theoretical Underpinnings of a Global Social Contract
In modeling a global social contract, theoretical underpinnings are provided, drawing from Jean-Jacques Rousseau’s The Social Contract and John Locke’s Two Treatises of Government. The thoughts of these two great philosophers regarding democracy have been insufficiently examined, reflecting the constraints of life in 17th- and 18th-century Geneva and England, respectively. It is on this basis that their ideas may be adapted to what may be called global democracy in the dawn of the new millennium. The key drivers of their concepts of democracy were empathy and compassion (for Rousseau) and human reason and pragmatism (for Locke). Given the technological, economic, political, social, and cultural environments at the dawn of the new millennium, captured by accelerated globalization and digitalization, transnational direct democratic and transnational representative democratic models of a global social contract are feasible and justified (see Inoguchi & Lien, 2016). To illustrate this dramatic change, a contrast is made between the years 1912 and 2016–1912 when Normal Angel forecast the advent of peaceful years ahead and 2016, at the time of this writing.
Attitudes Toward LGBT People and Rights in Africa
Jocelyn M. Boryczka
Capturing the nuanced attitudes toward LGBT (lesbian, gay, bisexual, transgender) people and rights in Africa involves examining them from within and outside the African context. Constructions of the entire African continent as holding negative attitudes toward LGBT peoples and denying them any rights remain quite commonplace across the Global North. However, closer analysis of specific nation-states and regions complicates our understanding of LGBT people and rights in Africa. Advances in the global study of LGBT attitudes through tools such as the Global LGBTI Inclusion Index and the Global Acceptance Index survey African peoples’ beliefs about LGBT communities. These measures locate African attitudes about LGBT peoples within a comparative context to decenter assumptions and many inaccurate, often colonialist, constructions. Attitudinal measures also expose the gap between legislation securing formal rights and the beliefs driving peoples’ everyday practices. These measures further specify how African governments can, often in response to Western political and economic forces, leverage homophobia on a national level to serve their interests despite a misalignment with the population’s attitudes toward LGBT peoples. Nongovernmental organizations and advocates raise awareness about LGBT rights and issues to impact socialization processes that shape these attitudes to generate political, social, and economic change. A rights-based approach and research on attitudes emerging from the African context represent shifts critical to better understanding how LGBT peoples and rights can be more effectively advanced across the continent.
Antimicrobial Resistance as a Global Health Crisis
Erik Baekkeskov, Olivier Rubin, Louise Munkholm, and Wesal Zaman
Antimicrobial resistance (AMR) is a global health crisis estimated to be responsible for 700,000 yearly deaths worldwide. Since the World Health Assembly adopted a Global Action Plan on AMR in 2015, national governments in more than 120 countries have developed national action plans. Notwithstanding this progress, AMR still has limited political commitment, and existing global efforts may be too slow to counter its rise. The article presents five characteristics of the global AMR health crisis that complicate the translation from global attention to effective global initiatives. AMR is (a) a transboundary crisis that suffers from collective action problems, (b) a super wicked and creeping crisis, (c) the product of trying to solve other global threats, (d) suffering from lack of advocacy, and (e) producing distributional and ethical dilemmas. Applying these five different crisis lenses, the article reviews central global initiatives, including the Global Action Plan on AMR and the recommendations of the Interagency Coordination Group on AMR. It argues that the five crisis lenses offer useful entry points for social science analyses that further nuance the existing global governance debate of AMR as a global health crisis.
Non-State Actors and Foreign Policy
Frank A. Stengel and Rainer Baumann
The rise of non-state (international, private, and transnational) actors in global politics has far-reaching consequences for foreign policy theory and practice. In order to be able to explain foreign policy in the 21st century, foreign policy research needs to take into account the growing importance of nonstate actorss. A good way to do this would be to engage the literature on globalization and global governance. Both fields would benefit from such an exchange of ideas because their respective strengths could cancel out each other’s weaknesses. Foreign policy research, on the one hand, has a strong track record explaining foreign policy outcomes, using a broad range of theoretical concepts, but almost completely ignores non-state actors. This is highly problematic for at least two reasons: first, foreign policy is increasingly made in international organizations and intergovernmental and transnational governance networks instead of national institutions like foreign ministries. Second, the latter increasingly open up to, and involve, non-state actors in their policymaking procedures. Thus, if foreign policy research wants to avoid becoming marginalized in the future, it needs to take into account this change. However, systemic approaches like neorealism or constructivism have difficulties adapting to the new reality of foreign policy. They stress the importance of states at the expense of non-state actors, which are only of marginal interest to them, as is global governance. Moreover, they also conceptualize states as unitary actors, which forecloses the possibility of examining the involvement of non-state actors in states’ decision-making processes. Agency-based approaches such as foreign policy analysis (FPA) fare much better, at least in principle. FPA scholars stress the importance of disaggregating the state and looking at the individuals and group dynamics that influence their decision-making. However, while this commitment to opening up the state allows for a great deal more flexibility vis-à-vis different types of actors, FPA research has so far remained state-centric and only very recently turned to non-state actors. On the other hand, non-state actors’ involvement in policymaking is the strong suit of the literature on globalization and global governance, which has spent a lot of time and effort analyzing various forms of “hybrid” governance. At the same time, however, this literature has been rather descriptive, so far mainly systematizing different governance arrangements and the conditions under which non-state actors are included in governance arrangements. This literature could profit from foreign policy research’s rich theoretical knowledge in explaining policy outcomes in hybrid governance networks and international organizations (IOs). Foreign policy researchers should take non-state actors seriously. In this regard, three avenues in particular are relevant for future research: (1) comparative empirical research to establish the extent of non-state actors’ participation in foreign policymaking across different countries and governance arrangements; (2) explanatory studies that analyze the conditions under which non-state actors are involved in states’ foreign policymaking processes; and (3) the normative implications of increased hybrid foreign policymaking for democratic legitimacy.
Historical Views of Homosexuality: European Colonialism
The history of colonialism encompassed diverse meetings between societies and cultures, providing chances for discovery (by both the colonizing and the colonized) of differing sexual attitudes and behaviors. Varying sexual cultures inspired European ethnographical research, relativised sexual certainties and incited both fantasies and moral concern. Eroticised images of foreign men appeared in art, and affective relationships between Europeans and non-Europeans featured in literary works. The sex lives of “natives” and Europeans overseas provided subjects of speculation. The conquest of overseas territories by European and other expanding powers also led to the imposition of Western law codes regulating sexuality, including same-sex relations, gender norms, and marriage. Prohibitions on “sodomy” entered law codes throughout the British Empire, often with provisions of severe penalties. Only in the late 1900s did decriminalization occur in the British settler Dominions, though less often in former colonies in Africa, Asia, and the Caribbean. For European countries where same-sex activity had been decriminalized, such as France, it generally remained legal in the colonies, though surrounded with taboos and social opprobrium. Same-sex desire (and relations between Europeans or between them and indigenous people) appeared in many forms in colonial societies and in the lives of men associated with overseas empires. It was castigated by authorities as a menace to colonial mores but experienced by some men in the colonies as an opportunity for pleasure and a source of male bonding; non-Western sexual cultures provided arguments for both campaigns of “moralization” and for homosexual emancipation in Europe. Occasional scandals underscored the ways in which debates about sexual difference intertwined with colonial-era attitudes and policies.
LGBTI Transnational Law: Sex as Crime, Violence as Control
Berta Esperanza Hernandez-Truyol
It is impossible to divorce the criminalization of LGBTI conduct from the social, institutional, and extra-legal violence to which individuals within this community are subjected, as laws are a mirror of a society’s values. The foundation for laws that punish non-hetero-normative sexualities and gender expressions are societal constructions of hetero-normativity. Lawmakers codify their generalized views about what roles persons should fulfill or perform based on preconceptions regarding the attributes, behaviors, or characteristics of a person, class, or group. Non-hetero-normative sexual orientations and gender identities challenge traditional notions of sexuality and gender. Violence is used as a way to control the bodies of those who exhibit non-heteronormative traits and values, as well as a form of social control to reinforce sexual and gender norms. The distinctions countries create in the targeted illegality of “male” and “female” homosexuality demonstrate the conflation of sex, gender identity, and sexual orientation. Laws that ban expressive conduct and effectively eliminate lesbian, gay, bisexual, transgender, and intersex (LGBTI) persons from public discourse have historical roots in Christian and Muslim religious traditions. Whether codified or not, violence against LGBTI individuals is a consequence of deeply embedded gender inequality. Such inequality manifests in social and physical violence that ultimately punishes, controls, and erases LGBTI persons. Although international bodies have reacted against such violence by ratifying legal instruments to protect the LGBTI community, changing social conditions and preconceptions has proven to be the most effective route to protecting LGBTI persons’ human rights.
HIV/AIDS Politics and Policy in Sub-Saharan Africa
Catherine van de Ruit
Sub-Saharan Africa has the world largest proportion of adults and children living with AIDS. To mitigate the multiple consequences of the epidemic, novel forms of governance arose as international organizations usurped the roles traditionally played by states; new funding streams emerged that led to asymmetries in biomedical resource allocation; and diverse partnerships among international agencies, nation-states, and local and international nongovernmental organizations emerged. Global health actors attempted to define AIDS policy and programming as an apolitical biomedical intervention. However, political dynamics were evident in the negotiations between international donors and African state bureaucracies in setting AIDS policy agendas and the contestations between African and international social movements and global health agencies over AIDS treatment drug prices and access to treatment interventions across the continent. During the first two decades of the African AIDS epidemic (1980–2005) the dominant approach to AIDS disease mitigation was the focus on AIDS prevention, and across sub-Saharan Africa standardized prevention interventions were introduced. These interventions were founded upon limited evidence and ultimately these programs failed to stem rates of new HIV infections. Social movements comprising coalitions of local and international activists and scientists brought extensive pressure on global health institutions and nation-states to reform their approach to AIDS and introduce antiretroviral therapy. Yet the path toward universal provision of antiretroviral treatment has been slow and politically contentious. By the second decade of the 21st century, antiretroviral therapy interventions together with AIDS prevention became the dominant policy approach. The introduction of these initiatives led to a significant decline in AIDS-related mortality and slowed rates of transmission. However, health disparities in treatment access remain, highlighting ongoing shortcomings in the political strategies of global health agencies and the public health bureaucracies of African states.