The first cases of acquired immunodeficiency syndrome (AIDS) appeared in the late 1970s and the disease rapidly developed into an international epidemic in the 1980s. Some countries in Africa have been particularly hard hit, with a large proportion of the population infected. Sweden was among the countries that joined the response early on and has, over the following four decades, contributed significant resources to it. But how has the Swedish HIV response evolved over these 40 years, and what lessons can we learn from this long effort?
The EBA report The Swedish Aid Response to the HIV Epidemic: An Overview (2023:03) presents a descriptive analysis of Sweden’s international response to the HIV epidemic from the mid-1980s to the present day. It analyzes three parts of Sweden’s HIV response – the support to the Global Fund, the regional support to sub-Saharan Africa and the bilateral cooperation with Zimbabwe.
Based on an in-depth qualitative document analysis and interviews with 42 key actors in the Swedish HIV response, the authors draw four main conclusions:
- Sweden has been a pioneer in the field of sexual and reproductive health and rights (SRHR), which has been evident in its HIV response, as Sweden has advocated for preventive measures focusing on structural and socio-economic factors that contribute to a person’s risk of contracting HIV, such as poverty, inequality, and discrimination.
- The Swedish HIV response has been characterized by a broad and systematic approach, focusing on promoting and strengthening national health systems, as well as integrating the HIV response into the broader SRHR agenda.
- Sweden has been a strong advocate of evidence-based interventions and has provided substantial support for HIV research. This contributed to Sweden’s decision not to immediately invest in antiretroviral treatment (ART) in low- and middle-income countries, but has since become increasingly involved in ensuring access to ART.
- Despite being a small actor, Sweden has managed to gain influence in the multilateral cooperation. This has been due to the availability of competent and experienced experts and diplomats with both thematic expertise and knowledge of the global aid architecture, which has been crucial to Sweden’s ability to advocate its position in many areas of the global HIV response.