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LSE academic prescribes 'hope' in the battle against HIV/AIDS

'Hope' could be a valuable tool to enable policy makers to adopt the best policies to combat HIV/AIDS in Africa, an LSE professor has argued.

IAids ribbonn Social Policy: metaphors and hope, published this weekby the Copenhagen Consensus Center's HIV/AID's in Africa project, Professor Tony Barnett, LSE Health, examines the arguments and analyses made in another Rethink HIV paper on social policy, Social Policy: going upstream by academics at the London School of Hygiene and Tropical Medicine, and suggests that 'hope' might be an effective tool in establishing effective social policy.

Professor Barnett's paper has been published as part of Rethink HIV: the project, funded by the RUSH Foundation. The project commissioned leading health academics to analyze HIV policy choices and identify the most effective ways to tackle the pandemic across sub-Saharan Africa. Three papers were commissioned to focus on social policy, one Assessment Paper outlining the costs and benefits of at least three of the most promising responses, interventions and investments to HIV/AIDS in Sub-Saharan Africa, and two Perspective Papers reviewing the assumptions and analyses made within the first publication.

aidsProfessor Barnett's perspective paper was produced as a response to the Social Policy: going upstream by Charlotte Watts, Michelle Remme and Anna Vassal of the London School of Hygiene and Tropical Medicine, which presents an analysis of the costs and benefits of interventions that seek to address some of the key social drivers of HIV/AIDS vulnerability, and the social barriers to achieving a high coverage to proven HIV interventions.

"Development of social policy interventions in response to the HIV/AIDS epidemic has been framed in the language of metaphors." writes Professor Barnett, in his analysis. "Three critical metaphors have been unexamined – the metaphor of 'going upstream', the metaphor of a body undergoing treatment and the idea of 'drivers'. These three metaphors have been important in framing the questions to be addressed by cost benefit and cost effectiveness analysis but their use obscures some important problems which require working through before policy formulation."

In his paper, Professor Barnett examines the flaws with using each metaphor and goes on to suggest a possible diagnostic tool which does away with the need for these metaphors: hope.   

"Because the ideas of hope and hopelessness are probably translatable into most languages, the concept lends itself to deployment in techniques such as surveys, focus groups and other methods of data collection which could allow members of communities affected by HIV to be directly involved in dialogue (and even diagnosis) about how to improve the existing situation." Professor Barnett argues.

"Hope is also measurable using fairly straightforward scales, it is easily understood by politicians and others responsible for allocating resources and is also understood by ordinary people, who may be able to tell us directly what is required to restore hope and therefore directly inform policy."

"Where there is hope (and structural and other resources), individual behaviour change in response to rational argument is possible. Where hope and resources are absent, behaviour change messages are less likely to be effective on their own. Social policy interventions in the HIV epidemic which are based on diagnosis of the conditions which may make people hopeless may be the way forward, and ultimately these policy interventions may be both cost effective and cost beneficial." 

A second Perspective Paper was also written by Harounan Kazianga, Assistant Professor, Spears School of Business at the Oklahoma State University.

All three papers can be downloaded from


Contact: Professor Tony Barnett, a.s.barnett@lse.ac.uk

Or Jess Winterstein, LSE Press Office, 020 7107 5025, j.winterstein@lse.ac.uk

27 September 2011