Foreign Affairs reviews 'HIV Exceptionalism'

By Nicolas van de Walle
Foreign Affairs

Benton_HIVBenton’s analysis of the HIV/AIDS crisis in Sierra Leone begins by noting that the disease captures the majority of the resources going to the country’s health-care sector despite the fact that it afflicts only around one percent of the population, which arguably suffers far more from a myriad of other health problems. Benton provides many examples of the counterproductive incentives this imbalance creates within the sector, as many qualified health-care professionals rush into HIV/AIDS work even though far more are needed to help combat malaria and the other diseases that still hold back the people of Sierra Leone, which is still just barely recovering from a long and brutal civil war. The question hovering over the book is whether, in this context, HIV/AIDS is really an “exceptional” ailment that requires exceptional treatment. Benton’s answer leans toward no. Aside from tackling that conundrum, Benton also provides a keenly observed case study of the impact of foreign aid on local practices in very poor countries, when the resource flow is shaped almost entirely by donor priorities rather than local ones.

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