The Internal State Politics of ARV Providing Hospitals in South African and Nigerian States.

This paper is a preliminary analysis of why antiretroviral drug providing hospitals are located in the provinces they are in South Africa and Nigeria. I review literature on the politics of HIV/AIDS as well as past public policy research on policy inequity and state healthcare policy choices. I then build a model to test hypotheses behind hospital location choice. Independent variables are divided into public health, economic, political, and ethnic motivations. This paper also challenges using the national level as the exclusive unit of analysis in comparative politics research; it is clear from this work that significant variation exists within states, and such variation needs to be considered and modeled. With little work done focused on sub-state variation, the paper offers an important step, disaggregating and showing that institutions below the national level are critical in the fight against HIV/AIDS. My initial findings show support for AIDS prevalence rates and voting for the party in power for president as important factors that make ARV provision more likely. This finding indicates that public health resources are being distributed along political lines, both demonstrating the need for further political science research on this question as well as raising normative issues. Also significant were findings regarding oil, although these were not in the anticipated direction making ARV hospital provision less likely; findings indicate that the "resource curse" is more expansive than has been developed. Specifically, oil revenue appears to remove the need to tax, thus removing government incentives to provide health care resources. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]