This book studies the role of civil society organisations in the fight against HIV/AIDS in Russia. It looks at how Russia’s HIV/AIDS epidemic has developed into a serious social, economic and political problem, and how according to the United Nations Programme on HIV/AIDS (UNAIDS), Russia is currently facing the biggest HIV/AIDS epidemic in all of Europe with an estimated number of 980,000 people living with HIV in 2009. The book investigates civil society organisations’ contribution to social change and civil society development in post-Soviet Russia, and thus situates a specific type of civil society actors into a broader socio-political context and questions their ability to represent civic interests, particularly in the field of social policy-making and health. This allows for a better understanding of the dynamics of state-society relations in present-day Russia, and gives insight into the ways HIV/AIDS NGOs in Russia have used transnational ties in order to exert influence on domestic policy-making in the field of HIV/AIDS.

In the second half of the twentieth century, political scientists observed a remarkable increase in policy convergence across disparate issue areas. The literature on policy diffusion suggests that countries are likely to converge around internationally accepted norms of behavior. These include, for example, public health policies designed to deal with epidemics such as polio, tuberculosis, SARS, and HIV/AIDS. Most countries treat these epidemics in similar and in some cases almost identical ways. States where epidemics emerge relatively late are at an extraordinary advantage. They not only have the expertise of a number of international organizations and their technical assistance at their disposal, but also the experience of other states. Once successful policies to address such epidemics are identified, many states choose to adopt these approaches. However, when it comes to the prevention of HIV/AIDS, Russia's policy is an outlier. While the Russian Federation is facing the fastest growing HIV/AIDS epidemic in Eastern Europe, it remains one of the few states that refuses to implement key interventions. The goal of this dissertation is to examine why this is the case. I investigate the role of domestic factors in shaping HIV/AIDS policies in Russia. Existing literature suggests that the political regime, the development of civil society, and patterns of federalism are some of the factors that might explain variation in state responses to the HIV/AIDS epidemic. In contrast, I demonstrate that path-dependent factors, such as the influence of the medical epistemic community and the politics of morality, account for the absence of HIV/AIDS policy diffusion in Russia. I argue that in the Russian Federation, HIV/AIDS prevention policies are undermined due to lack of state will and centralized authority. Therefore, individual agencies conduct interventions without a specific mandate to prioritize a response to the HIV/AIDS epidemic. These agencies design and implement interventions in accordance with their established priorities, norms, and practices, which are strongly path-dependent. In particular, I show that institutionalized influence of the domestic medical epistemic community and the politics of morality on policy-making processes prevent the adoption of best practices in Russia's response to the HIV/AIDS epidemic.

Russia and a few other Eurasian countries have been home to the fastest growing epidemics of HIV in the world over the last several years. This volume offers country-specific accounts, authored by the leading players in the analysis of the situation and the fight against the virus.

Civil Society Organizations (CSOs) can make a vital contribution to public health and health systems but harnessing their potential is complex in a Europe where government-CSO relations vary so profoundly. This study is intended to outline some of the challenges and assist policy-makers in furthering their understanding of the part CSOs can play in tandem and alongside government. To this end it analyses existing evidence and draws on a set of seven thematic chapters and six mini case studies. They examine experiences from Austria Bosnia-Herzegovina Belgium Cyprus Finland Germany Malta the Netherlands Poland the Russian Federation Slovenia Turkey and the European Union and make use of a single assessment framework to understand the diverse contexts in which CSOs operate. The evidence shows that CSOs are ubiquitous varied and beneficial and the topics covered in this study reflect such diversity of aims and means: anti-tobacco advocacy food banks refugee health HIV/AIDS prevention and cure and social partnership. CSOs make a substantial contribution to public health and health systems with regards to policy development service delivery and governance. This includes evidence provision advocacy mobilization consensus building provision of medical services and of services related to the social determinants of health standard setting self-regulation and fostering social partnership. However in order to engage successfully with CSOs governments do need to make use of adequate tools and create contexts conducive to collaboration. To guide policy-makers working with CSOs through such complications and help avoid some potential pitfalls the book outlines a practical framework for such collaboration. This suggests identifying key CSOs in a given area; clarifying why there should be engagement with civil society; being realistic as to what CSOs can or will achieve; and an understanding of how CSOs can be helped to deliver.

This book studies the role of civil society organisations in the fight against HIV/AIDS in Russia. It looks at how Russia’s HIV/AIDS epidemic has developed into a serious social, economic and political problem, and how according to the United Nations Programme on HIV/AIDS (UNAIDS), Russia is currently facing the biggest HIV/AIDS epidemic in all of Europe with an estimated number of 980,000 people living with HIV in 2009. The book investigates civil society organisations’ contribution to social change and civil society development in post-Soviet Russia, and thus situates a specific type of civil society actors into a broader socio-political context and questions their ability to represent civic interests, particularly in the field of social policy-making and health. This allows for a better understanding of the dynamics of state-society relations in present-day Russia, and gives insight into the ways HIV/AIDS NGOs in Russia have used transnational ties in order to exert influence on domestic policy-making in the field of HIV/AIDS.

Although adopting global norms often improves domestic systems of governance, domestic obstacles to norm diffusion are frequent. States that decide to reinvent their political authority simultaneously evaluate which current global norms are desirable and to what extent. In this study, Vlad Kravtsov argues that recent debates about the nature of authority in Putin’s Russia and Mbeki’s South Africa have resulted in a set of unique ideas on the cardinal goals of the state. This is the first book to explore how these consensual ideas have shaped health governance and impinged on norm diffusion processes. Detailed comparisons of HIV/AIDS governance systems in Russia and South Africa illustrate the argument. The Kremlin’s dislike of international recommendations stemmed from the rapidly maturing statism and great power syndrome. Pretoria’s responses to global AIDS norms were consistent with the ideas of the African Renaissance, which highlighted indigenousness, market-based empowerment, and moral leadership in global affairs. This book explains how and why the governments under investigation framed the nature of the epidemic, provided evidence-based prevention services, increased universal access to proven lifesaving medicines, and interacted with other participants in social practice.