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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.

Article

The Politics of Language Education in Africa  

Russell H. Kaschula and Michael M. Kretzer

Language policies in sub-Saharan African nations emerge out of specific political, historical, socioeconomic, and linguistic conditions. Education plays a crucial role for all spheres of language policy. Policies either upgrade or downgrade indigenous languages through their application at various educational institutions. The most significant example is the selection of the language(s) used as languages of learning and teaching at higher-education institutions. The region’s colonial history also influences the language policies of the independent African states. Language policy in Senegal is an example of a francophone country focusing on a linguistic assimilation policy in which minor reforms in favor of indigenous languages have taken place. Rwanda’s language policy is unique as the former francophone nation now uses English as an exoglossic language in a type of hybrid language policy. Botswana is an example of an anglophone country that follows a language policy that is dominated by a very close connection to the notion of nation-building through its concentration on a single language, Setswana, alongside English. Tanzania is an anglophone African country whose policy focuses on Kiswahili, which is one of the very few indigenous and endoglossic languages. Kiswahili is broadly used in Tanzanian educational institutions until the tertiary level, but its use as medium of instruction focuses on the primary level. South Africa demonstrates the very close relationship between general political decisions and language policy and vice versa. Language policy decisions are never neutral and are influenced by the politics of a specific country. As a result, individual and societal language attitudes influence language policies. In addition to this, the overt and official language policy on a macro level may differ from the implementation of such policies on a micro level. At the micro level, practice can include covert language practices by various stakeholders.