Canada's international response to HIV during times of global transition: a qualitative inquiry.

BACKGROUND

Canada's international response to HIV may be under threat given CIDA's new aid priorities that appear to exclude health. Drivers of this recent priority shift have been the influence of global aid trends among public sector donors and changes within the global HIV milieu itself. However, this is not the first time Canada has shifted in response to these two global trends. The era from 2000-2004 also witnessed dramatic changes in both the HIV field and in global thinking around international aid. As such, this article presents an evaluation of the Government of Canada's international response to HIV during the first era of transition (2000-2004) in order to derive lessons for decision-making around HIV in the current climate of change.

METHODS

In-depth, semi-structured interviews were conducted with 23 key informants with expertise regarding Canada's international response to HIV over time. Analysis involved multiple readings of transcripts to identify descriptive codes and establish intimacy with the data. Descriptive codes were then collapsed into thematic categories using a process of inductive reasoning.

RESULTS

Canada's international response to HIV was perceived to be exemplary at times (e.g. seminal funding to WHO's "3-by-5" strategy), but also inconsistent (e.g., underutilized technical assistance capacity) and non-strategic (e.g., contradiction between investing in training health providers while poaching professionals to bolster Canada's workforce).

CONCLUSIONS

Lessons from the 2000-2004 era of transition focus on strategic investments, the inextricable connection between HIV and development and strategy coherence. These results highlight that it is more constructive to ensure that Canadian development responses in all areas engage with both the upstream drivers of HIV as well as the impacts of the epidemic itself in order to achieve the greatest results from international investment and the most effective contributions to the lives of the people that these endeavours seek to support.