This document discusses HIV policy issues and provides a framework for analyzing public policies related to HIV. It defines policy and outlines the policymaking process. It also identifies some key HIV policy issues such as access to voluntary counseling and testing, antiretroviral treatment, and mandatory testing. Additionally, it presents a practical framework for linking research to policymaking by understanding the political context, presenting relevant evidence, and building relationships with stakeholders.

1. HIV POLICY ISSUES
Omid Zamani
MD, MPH

2. POLICY:
 a set of decisions that give rise to specific
proposals for action.
 A general rule adopted to influence and determine
decisions or procedures.
 Many people equate policy with legislation, but it
also includes non-legislative decisions such as
setting standards, allocating resources between
organizations, changing the levels of subsidies or
taxes or consulting specific groups in the policy-making
process.

3. POLICY ISSUES
Policy issues may include;
 the absence of a policy,
 an adverse or inadequate policy, or
 the improper enforcement of a policy.

4. HIV EPIDEMIC – DETERMINANTS AND
RESPONSES – UPSTREAM CAUSES
Biomedical
Virus sub-types
Stage of
infection
Presence of
other STDs
Gender
Circumcision
Other
HIV Infection
Aids
Sexual behaviour
Rate of partner
change
Concurrent
partners
Sexual mixing
patterns
Sexual practices
Condom use
Other
Micro-environment
Mobility
Urbanisation
Access to health
care
Levels of
violence
Women’s rights
and status
Other
Macro-environment
Wealth
Income distribution
Culture
Religion
Governance
Other
Source: Whiteside ODI Presentation, 2003.

5. SOME EXAMPLES
 Free VCT provision
 Free ARV provision
 Compulsory Testing
 Migration and mobility
 Guardianship and adoption
 Population growth
 War on drugs

6. POLICY TRIANGLE

7. Policy Processes
1. Problem Definition/
Agenda Setting
2. Constructing the Policy
Alternatives/ Policy Formulation
3.Choice of Solution/
Selection of Preferred Policy Option
4. Policy Design
6. Evaluation
5. Policy Implementation
and Monitoring
The Policy Cycle

8. A PRACTICAL FRAMEWORK
External Influences political context
links evidence
Campaigning,
Lobbying
Politics and
Policymaking
Media,
Advertising,
Networking Research,
learning &
thinking
Scientific
information
exchange &
validation
Policy analysis, &
research

9. USING THE FRAMEWORK
 The external environment: Who are the key actors? What
is their agenda? How do they influence the political context?
 The political context: Is there political interest in change? Is
there room for manoeuvre? How do they perceive the
problem?
 The evidence: Is it there? Is it relevant? Is it practically
useful? Are the concepts familiar or new? Does it need re-packaging?
 Links: Who are the key individuals? Are there existing
networks to use? How best to transfer the information? The
media? Campaigns?

10. POLICY INFLUENCING APPROACHES

11. PUTTING IT INTO PRACTICE
What researchers
need to know
What researchers
need to do
How to do it
Political Context:
• Who are the policymakers?
• Is there demand for ideas?
• What is the policy process?
Evidence
• What is the current theory?
• What are the narratives?
• How divergent is it?
Links
• Who are the stakeholders?
• What networks exist?
• Who are the connectors,
mavens and salesmen?
• Get to know the policymakers.
• Identify friends and foes.
• Prepare for policy
opportunities.
• Look out for policy windows.
• Work with them – seek
commissions
• Strategic opportunism –
prepare for known events
+ resources for others
• Establish credibility
• Provide practical solutions
• Establish legitimacy.
• Present clear options
• Use familiar narratives.
• Build a reputation
• Action-research
• Pilot projects to generate
legitimacy
• Good communication
• Get to know the others
• Work through existing
networks.
• Build coalitions.
• Build new policy networks.
• Build partnerships.
• Identify key networkers,
mavens and salesmen.
• Use informal contacts

12. STAKEHOLDER MAPPING CHART

13. STAKEHOLDER ANALYSIS
1. What are the stakeholders’ concerns and interest?
2. What do the stakeholders expect from HIV
programs in your district/region/ province?
3. What do you need to do to meet the stakeholders’
expectations? Or to avoid confrontation?

14. POLICY ANALYSIS DIMENSIONS

15. RESOURCES
 A Framework for Analyzing Public Policies: Practical
Guide, The National Collaborating Centre for Healthy Public
Policy (NCCHPP), Canada, 2012 www.ncchpp.ca
 Bridging the Gap between Research and Policy in
Combating HIV/AIDS in Developing Countries. Overseas
Development Institute, 2004
 ROMA: a guide to policy engagement and influence.
Overseas Development Institute, 2014 www.odi.org.uk/rapid/
 Evidence-Based Planning for Sustainability of
Government Reproductive Health Services. PathFinder
International, 2008
 Advocacy Tools and Guidelines; Promoting Policy
Change. CARE 2001
 Evidence-informed Health Policy. presentation by Arash
Rashidian MD PhD EMRO regional workshop on Knowledge
Translation and Exchange, 2009

16. OMID ZAMANI
MD, MPH
 Researcher, Regional Knowledge Hub for HIV/AIDS
Surveillance
 Member of Medical and Health Sociology Scientific
Group, Iranian Sociological Association
 Member of Environment & Health Communication Sci
entific Group, Iranian Association of Cultural Studies
& Communication
 Email: Omid@zamani.info
 Web: http://zamani.info