Divided Over Disease

What explains why some countries aggressively fight AIDS, while others are slow to act? Conventional explanations often blame poverty or poor political leadership. But new research has identified an additional factor: ethnic divisions. The more ethnically fragmented a country, the less aggressively its government tackles HIV/AIDS. In countries with highly fractionalized populations, governments spend less ...

What explains why some countries aggressively fight AIDS, while others are slow to act? Conventional explanations often blame poverty or poor political leadership. But new research has identified an additional factor: ethnic divisions. The more ethnically fragmented a country, the less aggressively its government tackles HIV/AIDS.

What explains why some countries aggressively fight AIDS, while others are slow to act? Conventional explanations often blame poverty or poor political leadership. But new research has identified an additional factor: ethnic divisions. The more ethnically fragmented a country, the less aggressively its government tackles HIV/AIDS.

In countries with highly fractionalized populations, governments spend less per capita on HIV prevention and treatment, and a smaller fraction of infected people gain access to antiretroviral drugs. In fact, when it comes to sub-Saharan African countries with high HIV rates, those countries least divided along ethnic lines can be expected to outspend the most divided ones by a factor of five.

The lack of action against AIDS in divided societies may stem from the belief that risks aren’t shared. "Elites, as well as ordinary citizens, [are] more inclined to believe that the risks of [HIV] infection [are] not their problem, but the other group’s problem," says Evan Lieberman, a political scientist at Princeton University and the author of the study recently published in Comparative Political Studies.

Similarly, there may be fears that taking a stand against AIDS can brand a particular group as diseased. "Groups [with higher HIV rates] have been more likely to either discount the risk of [HIV] or to try to underplay it for fear of stigmatizing their own group," says Lieberman. Donors looking to support HIV efforts may be wise to look at a society’s ethnic composition before setting their priorities. Because, apparently, it does take a village to vanquish a virus.

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