An Institutional Account of China's HIV/AIDS Policy Process from 1985 to 2010

Abstract

China's HIV/AIDS policy progress displays a long-term stagnancy followed by a sudden revolution. This article utilizes multiple theoretical tools to interpret this policy progress. It identifies four phases of China's HIV/AIDS policy process: (1) institutional endurance interpreted by path dependence from historical institutionalism;(2) deinstitutionalization explained by Oliver's antecedents of deinstitutionalization; (3) the radical shift interpreted by Kingdon's agenda-setting theory; and (4) reinstitutionalization and diffusion of institutional theory. This study demonstrates the utility of "creative borrowing"-employing multiple theoretical tools to harness the strengths of each. Doing so reveals that a country's past experience with similar policy issues, the perceived political and moral legitimacy of existing policies, and a country's existing political interests can exert resistance to change. In the presence of multiple pressures for change, policy entrepreneurs who can identify policy windows and couple multiple streams may achieve radical policy shifts. abstract El progreso legislativo relacionado al VIH/SIDA en China muestra un estancamiento a largo plazo seguido de una revolución repentina. El objetivo de este estudio es utilizar múltiples herramientas teoréticas para interpretar este progreso legislativo. Se identifican cuatro fases en el progreso de la legislación china sobre el VIH/SIDA: (1) Resistencia Institucional, interpretada por la dependencia al modelo del institucionalismo histórico; (2) Desinstitucionalización, explicada por los antecedentes de desinstitucionalización de Oliver; (3) el Cambio Radical, interpretado por la teoría del establecimiento de agendas políticas de Kingdon, y (4) Reinstitucionalización y Difusión de la teoría institucional. Este estudio muestra la utilidad del "préstamos creativo"-el empleo de múltiples herramientas teóricas para aprovechar las fortalezas de cada una. Este estudio revela que experiencias pasadas con temas legislativos similares, la percepción de legitimidad política y moral de las políticas existentes, y los intereses políticos existentes en el país pueden ejercer una resistencia al cambio Dada la presencia de múltiples presiones para el cambio, emprendedores políticos que identifiquen oportunidades en las políticas y combinen múltiples enfoques pueden lograr cambios políticos radicales.

Political repression, civil society and the politics of responding to AIDS in the BRICS nations

“…China's government joined Brazil and Russia in failing to immediately respond to AIDS, which first appeared in 1985. While a phalanx of State Council laws and regulations were created beginning in 1986, there was no well-established, co-ordinated effort to introduce prevention and treatment policies (Knutsen 2012). Furthermore, despite the government's commitment to decentralizing healthcare responsibilities, provincial governments lacked the resources needed to mount a strong policy response (Knutsen 2012).…”

“…In Brazil and South Africa-our two most divergent cases-the disease first appeared in the early 1980s, primarily among men who have sex with men (MSM) and injecting-drug users (IDU) in Brazil (Nattrass 2004) and among MSM men in South Africa (Williamson and Martin 2005). In China, the first indigenous outbreak occurred in 1989 among IDUs (Knutsen 2012). Russia's first cases spread throughout the MSM community, then to IDUs (Brown 2006).…”

A Qualitative Study of HIV/AIDS Social Policy Implementation in Rural Central China: Recipient Perspectives

“…According to existing research (Huang, 2006;Knutsen, 2012;Heather, 2004), there has been a fundamental change in China's HIV/AIDS policy since 2003. This shift in policy was partially facilitated by the SARS outbreak as well as a change in national leadership, which focused on addressing the needs of economically vulnerable PLWHA.…”

“…This shift in policy was partially facilitated by the SARS outbreak as well as a change in national leadership, which focused on addressing the needs of economically vulnerable PLWHA. Existing public health approaches were replaced by governmental approaches that focused on care, assistance, and support of PLWHA (Knutsen, 2012). The "Four Frees and One Care" symbolized this shift in the government's policy towards socio-economic issues of assistance and care.…”

A policy window and a network of global and local policy entrepreneurs: The introduction of opioid substitution therapy in Belarus

“…The MSF originally focused on policymaking in democratic regimes and on the influence of domestic policymakers. The MSF is now increasingly being applied to non-democratic regimes (e.g., Bindman, Kulmala, & Bogdanova, 2019;Huang, 2006;Knutsen, 2012;Mu, 2018;Peng, Skinner & Sperling, 2018;Schlaufer, 2019a;van den Dool, 2020;Wan, Chen & Sperling, 2018;Zhou and Feng 2014;Zheng, 2017), and recent studies have included the role of international actors (Bache, 2013;Bache & Reardon, 2013;Cairney, 2009;Lovell, 2016;Shephard et al, 2020). We draw on this recent literature to argue that in nondemocratic regimes, global policy entrepreneurs may play a prominent role to introduce new policy ideas.…”