Overall, there are improvements in the coordination of the role of stakeholders in policies and the policymaking process. This could be attributed in part to the influence of the comprehensive MDG adopted by the South African government in its comprehensive treatment policy. However, there are areas for improvement such as consultation of people living with HIV and community or traditional leaders to achieve accuracy or focus in identifying and selecting from policy options.
The elements of a good policy comprise the point of reference in assessing the fit between the problem identified and the solution selected with implications on budget allocation and the setting of measurable targets to assess progress (Bardach, 2008). There should be alignment or consistency in the problem identified, the policy options considered, the selected policy, the supporting objectives, the budget allocation, and measurable targets to justify the implementation of a particular national policy to resolve the HIV/AIDS problem.
In the case of the intervention policy, the problem identified that requires policy determination is the increasing rate of HIV infection in South Africa. The problem is clear enough and of strong significance to warrant policy determination. However, there may be an inaccurate consideration of HIV as a problem. The policy treats HIV as a separate health issue, when other health and social issues correlate with HIV. Based on the trends in policymaking, the South African government had two considerations for its policy options.
One, it can either opt for government intervention in addressing the health issue of HIV/AIDS or rely on private sector initiative through the actions of non-government and other private sector organisations. These choices have different implications on the role of the government in solving the problems and the policymaking process. Had the government opted for private sector initiative, then it has a flawed policymaking process, since HIV/AIDS is a serious problem requiring public sector solutions.
The selection of government intervention as an option then aligns with the nature of the problem subject to policymaking. With the selection of government intervention as the preferred option, the government then faced the alternative policy of focusing on national initiative and control or go for decentralisation to the local government. Decentralisation works well in government structures with fully functioning autonomous local governments, which South Africa does not have.
This means that while South Africa should work on improving its local government system, the intervention policy requires development at the level of the national government. After selecting national control, the next policy consideration is whether to adopt a short or long-term intervention. The South African government set the intervention policy to bring results in five years, making this a short-term policy. On one hand, the rate of HIV infections could decrease in five years with the implementation of the policy.
On the other hand, although the problem is the rising rate of HIV infections, this is a complex problem, which cannot be resolved in just five years. While the rate of HIV infection could decrease, this may not be sustainable. The objectives were comprehensive enough to cover prevention and treatment of HIV as well as research to improve treatment programs and provision of treatment in a humane manner. These objectives fit the requirements of the identified problem.