The development of health policymaking in South Africa coincides with its apartheid history (Baldwin-Ragaven, de Gruchy & London, 1999) that led to the limited attention given to health institutions and issues (Penn-Kekana & Blaauw, 2002). Before the shift in the form of governance in 1994, South Africa did not have clear policies on specific health issues such as maternal health and HIV/AIDS. This also meant lack of coordination in health response protocols.
The practice was for each government department or ministry to take initiative in developing their respective protocols in addressing issues within their scope of work. However, improvements in health policymaking occurred after the transition in governance to a democratic system when health issues received prioritisation by the government (Penn-Kekana & Blaauw, 2002). During the transition stage, the South African government attempted to improve the health system through policy reforms (Klugman, 1999; 2001).
Now, this effort continuous as the country seeks to fulfil its commitment to achieve the health-related goals contained in the millennium development goals. In the specific health issue of HIV/AIDS, the policymaking on this area was slow. It was only in 2003 that the government implemented the policy providing for public access to antiretroviral drugs intended to provide free treatment to 1. 2 million individuals living with HIV in the different communities before the end of 2008.
An influencing factor in this policy is the permission from the major pharmaceutical companies to allow the production and distribution of generic versions of antiretroviral drugs to developing countries. The treatment program comprises only an aspect of the government’s operational plan for the comprehensive treatment and care of people living with HIV drafted by the health department. The plan includes an information drive, community partnerships, and support for the families of people with HIV. The government has allotted a budget for this program.
(Marshall, 2004) The adoption of antiretroviral treatment was due to international pressures particularly the obligation of South Africa to fulfil its obligation to the millennium development goals, particularly in combating HIV/AIDS. While these sources describe the activities or programs engaged into by the South African government to address the health issue of HIV/AIDS, these do not explain the policymaking process including the policy options considered by the government and what policies were selected.
The present study seeks to fill this knowledge gap through policy analysis. Most of the resources related to the study approach the topic on a theoretical basis and there are only a limited number of empirical studies. While the sources provided a framework for the investigation, these also pointed to the need for empirical data on health policymaking and the factors influencing the process, which the current study on millennium development goals and combating HIV/AIDS in South Africa seeks to accomplish.
The aim of the study is to investigate the policies addressing HIV/AIDS in South Africa relative to the millennium development goals by using the policy analysis approach. Achieving this aim involved the development of a research methodology that addresses the data collection and analysis requirements of the study and meets ethical standards and expected quality of research. The chapter describes the research design, the methods of data collection, sampling strategy, research quality considerations, data management, and ethical issues before providing a conclusion.