The role of governance in mitigating an epidemic disease: evidence from HIV prevalence in 45 Sub-Saharan African countries, 1996–2019

Abstract

PurposeThis study proposed a theoretical framework to illustrate how governance can be instrumental in preventing the proliferation of HIV. It decomposed governance into six multidimensional facets and empirically examined their effects on HIV prevalence.Design/methodology/approachThe study utilized panel data from 45 sub-Saharan African countries from 1996 to 2019. HIV prevalence, the dependent variable, was estimated based on the number of adults aged 15–49 years infected with HIV, irrespective of the progression to AIDS symptoms. The independent variables included governance and its six dimensions: voice and accountability, political stability, government effectiveness, regulatory quality, rule of law, and control of corruption. The analysis incorporated the random and fixed effects models while controlling for economic development, economic inequality, foreign aid, sanitation, and population.FindingsThe findings revealed a significant association between good governance and lower HIV prevalence. Improved governance quality in sub-Saharan African countries has led to a reduction in HIV prevalence among adults. Specifically, governance dimensions, such as voice and accountability, political stability, rule of law, and control of corruption, contributed to reducing HIV prevalence. Conversely, government effectiveness and regulatory quality did not show significant impacts on HIV prevalence.Originality/valueThis study underscores the significant role of good governance in effectively curbing the spread of epidemic diseases, highlighting its importance in controlling HIV in sub-Saharan African countries.