Local Demand for a Global Intervention: Policy Priorities in the Time of AIDS

The success of global health and development interventions ultimately depends on local reception. This paper documents local demand for HIV/AIDS interventions in Africa and seeks to explain patterns of demand using data from a country hard-hit by AIDS. As international agencies and national governments scale up HIV/AIDS interventions in Africa, I find HIV-positive respondents more highly prioritize HIV/AIDS programs, however, cross-national opinion data paired with interviews of villagers and their headmen in rural Malawi show weak prioritization of HIV/AIDS. The data illustrate a misalignment of policy preferences in the global-to-local hierarchy, highlighting the import of studying preferences of intended beneficiaries. (C) 2012 Elsevier Ltd. All rights reserved.