HIV/AIDS in Sweden and the United Kingdom : policy networks 1982-1992

Abstract: The focus of this study is on the development and influence of HIV/AIDS policy networks in Sweden and United Kingdom during the period 1982-92, from the period when the lethal disease which was later named AIDS first appeared in the two countries, to the time when HIV/AIDS policy was integrated into the main policy field of infectious diseases. The networks are defined as structural arrangements between organisations and individuals, who are in frequent contact with one another in order to prevent HIV infection, to reduce the personal and social impact of HIV infection, and to care for those already infected.Actors on different levels of decision making power in the two countries; the formation and development of networks; and the role of these networks in the political processes, leading to established HIV/AIDS policies, are identified and compared. Primary sources such as government papers, parliamentary debates and committee hearings from both countries have been used. Other sources are printed material from regional and local authorities, and NGOs; monographs and articles written by medical historians, sociologists, and political science scholars; and interviews with politicians, experts, and NGO representatives.HIV/AIDS developed into an independent policy sub-sector within the health care sector in both countries, and in Britain also within the social service sector. A large number of actors were involved in the networks. The health services in general have often been described as professionalised networks, dominated by the medical profession. The doctors and other experts were crucial in proposing HIV/AIDS policies and implementing them, but the influence of NGOs representing patients, and groups at risk of infection, grew unusually strong.In Sweden, the National Commission was established in 1985, structured in line with the tradition of parliamentary ad hoc commissions. The Commission became the hub of a national network, involving political parties, central, regional and local authorities, concerned NGOs, and relevant experts. In United Kingdom, the AIDS unit in the Department of Health became the central coordinating point. Civil servants rather than politicians shaped the policy, whilst the influence of NGOs on the HIV/AIDS policy fluctuated over time. The centralized nature of the National Health Service delayed health promotion initiatives.In the study, two network models provide a set of concepts which have proved useful in analysing the policy formation during the first eleven years of the HIV/AIDS crisis. These concepts facilitated the comparison between Sweden and United Kingdom which showed that differences were caused not only by differences in political culture and the main organisational patterns, in this case the national health care systems. The formation of HIV/AIDS policy networks in both countries was also affected by their national combinations of tradition and ideology. Furthermore, the analysis has suggested that when a new policy field is identified around a crisis affecting whole populations, it should also be analysed with reference to other, interfacing policy fields.