In theory, democratic elections are an important political process that help to determine the success or failure of a country's overall political response to the HIV/AIDS epidemic. For political parties, election campaigns offer opportunities to raise awareness and spread information about HIV/AIDS, while competing for votes on the basis of how they would fight the epidemic if elected. For voters, elections are an opportunity to reward the governing party for a job well done - or to hold that party accountable for mistakes and inefficiencies that will cost lives and destroy communities. In reality, however, there is evidence to suggest that the very nature and scale of the HIV/AIDS epidemic is undermining its democratic remedy.
Some 20 years into the global pandemic, the issue of HIV/AIDS has undoubtedly featured in electoral processes the world over. In most cases though, HIV/AIDS has been a relatively peripheral policy issue that did not determine electoral outcomes. In Southern Africa - the region currently worst affected by the epidemic - the situation is very different. In several countries HIV prevalence is thought to be between 20% and 40% in the adult (15-49) population. HIV/AIDS is not only a central policy issue in the region, but a societal problem that impacts directly on the legitimacy of elections.2 Once elected assemblies are in place, HIV/AIDS continues to hamper the representative and legislative democratic process. For example, the resignation or death of a member of parliament (MP) due to HIV/AIDS results in the loss of a unique set of experiences, capabilities, trust, and political networks, as well as the representation of a constituency's political aspirations. In addition, considerable financial costs are incurred to hold the necessary by-elections for that MP's replacement. Social science research on these effects has produced few definitive conclusions; but it would be unethical and unrealistic not to analyse the data available (however sketchy it sometimes is), so long as the necessary caveats are stated clearly.
If the effect of HIV/AIDS on elections is not explored, the virus may count among its victims this institutionalised opportunity for democratic deliberation and decision making. In order to avoid any long-term detrimental effects of the impact of HIV/AIDS on the electoral process, we need to act swiftly based on the (albeit limited) knowledge that we have.
This paper explores the links between HIV/AIDS and electoral processes in Southern Africa. It begins by examining the implications of HIV/AIDS for democracy and governance generally. It then considers how the different institutional elements of elections vary in their vulnerability to the epidemic, and to what extent different institutional arrangements can be part of a strong political response.
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