Who Governs the Microbe? The Governance of Infectious Disease in Southern Africa
2009 Seed Grant
Despite substantial bio-medical knowledge concerning how to prevent the spread of infectious disease and treat related illnesses, health technologies are implemented in very different ways around the world, often with devastating consequences.
Lieberman's research has focused on identifying which authorities govern infectious disease, why this varies across space and with what consequences for service delivery. To date, his team has focused on collecting a great deal of data, including carrying out more than 80 interviews with governance authorities and service providers in four municipalities in one province of South Africa; fielding a survey of almost 300 municipal councilors in two South African provinces; commissioning a survey question on a national survey; and systematically coding news reports and related government documents. More recently, Lieberman traveled to Botswana and Zimbabwe to gain additional perspectives on governance patterns.
A few preliminary findings:
- The concurrent governance of HIV/AIDS by multiple authorities - "polycentric governance" - has impeded accountability and efficacy of service delivery in South Africa;
- Despite extremely high rates of mortality and morbidity from infectious disease, citizens and local government leaders tend to prioritize problems such as housing and jobs over HIV and Tb;
- Even in modern South Africa a large share of citizens and elites continue to look to traditional leaders to govern infectious disease, often to a greater extent than certain government authorities; and
- Female councilors are more likely than male councilors to emphasize the risks of infectious disease and to prioritize associated policies.
As part of this research, six Princeton undergraduates and two graduate students took part in extensive, summer-long field research trips. In addition, three South African students were hired to work with us.
All three undergraduates who worked on the summer 2008 team wrote senior theses related to the project — on the diffusion of policies across South African municipalities; the effects of ethnic diversity on public goods provision; and AIDS-related stigma. All three of the undergraduates from the summer 2009 team have pursued related coursework and/or written papers on related topics. One graduate student completed a research paper on traditional authority in sub-Saharan Africa; and another plans to use the councilor survey data in her doctoral dissertation.
The research has been presented in three courses: "Global Health Policy and Politics in the Developing Countries," "Politics in the Developing Countries," as well as an undergraduate politics workshop, "The Politics of Responding to Epidemics in Sub-Saharan Africa."
In April 2011, Lieberman presented his research at a UNAIDS-sponsored workshop on the Politics of HIV Policy in Bankgok, Thailand, which brought together political scientists and AIDS governance actors from around the world.
In 2010, Lieberman co-hosted The Judiciary and the Right to Health workshop with Joao Biehl. He also co-hosted The Distal Determinants of Public Health with John Gerring at Boston University. He has presented the research from this project at various universities, including Stanford and MIT
Lieberman will continue to conduct research and to teach about the governance of infectious disease, and plans to publish his findings in scholarly outlets. He also plans to conduct experimental research on the factors that affect risk perception among citizens and elites.