Decentralization has been recognized as a possible answer to some of the operational and coordination problems confronting AIDS control and prevention programs. Public health experts believe that a program of decentralization is needed to elicit a stronger multi-sectoral response to the epidemic and that it can accelerate the implementation of projects at all levels of society.
Many of the se efforts, however, may be proceeding with only limited understanding of why decentralization programs have failed in the past, or of the conditions necessary for them to succeed.
A properly planned and supported system of decentralization has the potential for expanding not only the associated organizations’ resource base, but also the funding and managerial talent that can be brought to bear on the AIDS epidemic. For this to happen, however, careful analysis and planning is needed to develop the political support, the policies, the support systems, and the institutional context in which those programs can succeed.