All change? Exploring the changes to World Bank policy and practice under the Multi-Country AIDS Programme (MAP)

Abstract

This paper critically examines whether change to World Bank policy and practice under James Wolfensohn’s Presidency (1995-2005) is both substantive and real. The paper uses the Bank’s seminal HIV/AIDS project ‐ the Multi-Country AIDS Programme (MAP) ‐ as a case study in which to explore this issue. Based upon extensive PhD fieldwork into the MAP in East Africa, the paper utilises key elements of the Wolfensohn change agenda: government ownership, civil society organisation engagement and multi-agency working, to assess whether change is real or mere rhetoric. The paper explores these issues in the following ways. First, it provides a brief background to change in the Bank, before discussing what is meant by change in this context and the research basis of the paper. Second, the paper explores the evidence for change, focusing on civil society organisation engagement, government ownership and multi agency working in turn. Third, evidence to suggest that such change is not substantive and cannot be verified is discussed. The paper then draws such evidence together and offers some conclusions as to whether change is substantive, and why this matters. In so doing, the paper argues that despite efforts to the contrary, the complexities of change and the institutional mechanisms within both the Bank and borrower countries make change unsubstantive and unreal.

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