Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
REVIEW

Resetting the agenda: the makings of ‘A New Era’ of HIV policy in NSW

Darryl O’Donnell A B and Diana Perche A
+ Author Affiliations
- Author Affiliations

A Department of Modern History, Politics and International Relations, Macquarie University, NSW 2109, Australia.

B Corresponding author. Email: dodon477@gmail.com

Sexual Health 13(4) 328-334 https://doi.org/10.1071/SH16010
Submitted: 30 March 2015  Accepted: 8 March 2016   Published: 21 April 2016

Abstract

The New South Wales Government’s NSW HIV Strategy 20122015: A New Era represented a punctuated shift of policy direction, and was remarkable for its ground-breaking declaration that HIV transmission could be virtually ended by 2020. This significant policy shift occurred after a long period of stability and only incremental change, some of it represented by policy decline as political and public interest in HIV waned. This article uses punctuated equilibrium theory to explore the conditions that allowed for change, and the roles played by new and long-standing actors in the HIV policy subsystem. It explains the importance of challenges to the policy image and the policy venue as key mechanisms that allowed new possibilities, created by advances in the scientific understanding of HIV, to be incorporated rapidly into government policy.


References

[1]  Duckett M. Australia’s response to AIDS. Canberra: Australian Government Publishing Service; 1986.

[2]  O’Donnell D, Grulich A, Garsia R, Parkhill N, Browne K. HIV in NSW in 2010: sustaining success in an evolving epidemic. N S W Public Health Bull 2010; 21 49–53.
HIV in NSW in 2010: sustaining success in an evolving epidemic.Crossref | GoogleScholarGoogle Scholar | 20513300PubMed |

[3]  McPherson ME, Ward KA. How does the HIV epidemic in NSW compare to other Australian jurisdictions and internationally? N S W Public Health Bull 2010; 21 55–60.
How does the HIV epidemic in NSW compare to other Australian jurisdictions and internationally?Crossref | GoogleScholarGoogle Scholar | 20513301PubMed |

[4]  The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2015. Sydney: The Kirby Institute; 2015.

[5]  NSW Ministry of Health. NSW HIV strategy 2012–2015: a new era. Sydney: NSW Ministry of Health; 2012.

[6]  NSW Ministry of Health. NSW HIV strategy 2016–2020. Sydney: NSW Ministry of Health; 2015.

[7]  True JL, Jones BD, Baumgartner FR. Punctuated equilibrium theory: explaining stability and change in public policymaking. In Sabatier PA, editor. Theories of the policy process. Boulder: Westview Press; 2007.pp. 97–116.

[8]  Baumgartner FR, Jones BD, Mortensen PB. Punctuated equilibrium theory: explaining stability and change in public policymaking. In Sabatier PA, Weible CM, editors. Theories of the policy process, 3rd edn. Boulder: Westview Press; 2014. pp. 59–103.

[9]  Jones BD, Baumgartner FR. The politics of attention. Chicago: University of Chicago Press; 2005.

[10]  Howlett M, Ramesh M, Perl A. Studying public policy: policy cycles and policy subsystems, 3rd edn. Oxford: Oxford University Press; 2009.

[11]  Baumgartner FR, Jones BD. Agendas and instability in American politics, 2nd edn. Chicago: University of Chicago Press; 2009.

[12]  John P, Bevan S. What are policy punctuations? Large changes in the legislative agenda of the UK Government, 1911–2008. Policy Stud J 2012; 40 89–108.
What are policy punctuations? Large changes in the legislative agenda of the UK Government, 1911–2008.Crossref | GoogleScholarGoogle Scholar |

[13]  Prindle DE. Importing concepts from biology into political science: the case of punctuated equilibrium. Policy Stud J 2012; 40 21–44.
Importing concepts from biology into political science: the case of punctuated equilibrium.Crossref | GoogleScholarGoogle Scholar |

[14]  Howlett M, Migone A. Charles Lindblom is alive and well and living in punctuated equilibrium land. Policy Soc 2011; 30 53–62.
Charles Lindblom is alive and well and living in punctuated equilibrium land.Crossref | GoogleScholarGoogle Scholar |

[15]  NSW Department of Health. A think tank: why are HIV notifications flat in NSW 1998–2006? – consensus statement. Sydney: NSW Department of Health; 2007.

[16]  NSW Department of Health. HIV/AIDS supported accommodation plan 2007–2010. Sydney: NSW Department of Health; 2008.

[17]  Green J, Eckstein G, Magee C, Carolan J. The NSW AIDS resource distribution formula: 2008 review – final report. Wollongong: Centre for Health Services Development, University of Wollongong; 2010.

[18]  Bernard D, Kippax S, Baxter D. Effective partnership and adequate investment underpin a successful response: key factors in dealing with HIV increases. Sex Health 2008; 5 193–201.
Effective partnership and adequate investment underpin a successful response: key factors in dealing with HIV increases.Crossref | GoogleScholarGoogle Scholar | 18686337PubMed |

[19]  Jansson J, Kerr CC, Mallitt K-A, Wu J, Gray RT, Wilson DP. Inferring HIV incidence from case surveillance with CD4+ cell counts. AIDS 2015; 29 1517–25.
Inferring HIV incidence from case surveillance with CD4+ cell counts.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2MXhsVOntrzL&md5=cca542c5af12635b1274cda3c5da0867CAS | 25870983PubMed |

[20]  Pedrana AE, Hellard ME, Wilson K, Guy R, Stoove M. High rates of undiagnosed HIV infections in a community sample of gay men in Melbourne, Australia. J Acquir Immune Defic Syndr 2012; 59 94–9.
High rates of undiagnosed HIV infections in a community sample of gay men in Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar | 21992925PubMed |

[21]  Birrell F, Staunton S, Debattista J, Roudenko N, Rutkin W, Davis C. Pilot of non-invasive (oral fluid) testing for HIV within a community setting. Sex Health 2010; 7 11–6.
Pilot of non-invasive (oral fluid) testing for HIV within a community setting.Crossref | GoogleScholarGoogle Scholar | 20152090PubMed |

[22]  Holt M, Mao L. Trends in HIV testing for gay and other homosexually active men. In de Wit J, Holt M, Hopwood M, Treloar C, editors. HIV/AIDS, hepatitis and sexually transmissible infections in Australia: annual report of trends in behaviour 2011. (Monograph 3/2011). Sydney: National Centre in HIV Social Research, University of New South Wales; 2011. pp. 15–16.

[23]  Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011; 365 493–505.
Prevention of HIV-1 infection with early antiretroviral therapy.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhtVars7jF&md5=5e8cfcb6a2f8c0e2d30e37ecdba2e326CAS | 21767103PubMed |

[24]  Vernazza P, Hirschel B, Bernasconi E, Flepp M. Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitment antirétroviral efficace ne transmettent pas le VIH par voie sexuelle. Bulletin des Médecins Suisses 2008; 89 165–9. [in French]

[25]  Wilson DP, Law MG, Grulich AE, Cooper DA, Kaldor JM. Relation between HIV viral load and infectiousness: a model-based analysis. Lancet 2008; 372 314–20.
Relation between HIV viral load and infectiousness: a model-based analysis.Crossref | GoogleScholarGoogle Scholar | 18657710PubMed |

[26]  Cohen MS. HIV treatment as prevention and ‘The Swiss statement’: in for a dime, in for a dollar? Clin Infect Dis 2010; 51 1323–4.
HIV treatment as prevention and ‘The Swiss statement’: in for a dime, in for a dollar?Crossref | GoogleScholarGoogle Scholar | 21034196PubMed |

[27]  Kingdon JW. Agendas, alternatives and public policies. Boston: Little, Brown and Co; 1984.

[28]  United Nations. Political declaration on HIV/AIDS: intensifying our efforts to eliminate HIV/AIDS. United Nations General Assembly, Sixty-fifth session; 8 July 2011; New York City, USA. Reference number: A/RES/65/277. New York: United Nations General Assembly; 2011.

[29]  Whittaker B. Australia should lead a global HIV prevention revolution. HIV Aust 2011; 9 7–8.

[30]  Whittaker B. Revolutionising HIV prevention and maximising treatment impact in Australia: meeting our commitment to implement the 2011 United Nations Declaration on HIV/AIDS. 1 December 2011.

[31]  Whittaker B. Revolutionising HIV prevention and maximising treatment impact in Australia: meeting our commitment to implement the 2011 United Nations Political Declaration on HIV/AIDS – progress report. August 2012.

[32]  Whittaker B. Revolutionising HIV prevention and maximising treatment impact in Australia: meeting our commitment to implement the 2011 United Nations Political Declaration on HIV/AIDS – progress report. October 2012.

[33]  Australasian Society for HIV Medicine. Communiqué: assisting clinicians in implementing the NSW HIV strategy 2012–2015: a new era. Sydney: ASHM; 2013.

[34]  Price K, Parkhill N. The importance of targets and regulatory reform to ending HIV. HIV Aust 2015; 13 17–9.

[35]  Action on HIV! The Melbourne declaration 2012: galvanising Australia’s HIV testing, prevention and treatment responses and meeting our commitments under the United Nations 2011 political declaration on HIV/AIDS. 2012. Available online at: https://www.afao.org.au/__data/assets/pdf_file/0017/25523/The-Melbourne-Declaration-2012.pdf [verified 31 March 2016].

[36]  Australian Federation of AIDS Organisations, et al. Implementing the United Nations political declaration on HIV/AIDS in Australia’s domestic HIV response: turning political will into action. Sydney: AFAO; 2012.

[37]  NSW Ministry of Health. NSW HIV strategy 2012–2015: a new era – snapshot, 2nd edn. March 2014. Sydney: NSW Ministry of Health; 2014.

[38]  ACON. Ending HIV. Sydney: ACON Health; 2016. Available online at: www.endinghiv.org.au/nsw [verified January 2016].