THE IMPACT OF POLITICAL INSTITUTIONS AND STATE CAPACITY ON ANTIRETROVIRAL DRUG COVERAGE : A CROSS COUNTRY ANALYSIS OF DETERMINANTS

Abstract:Using a cross-sectional regression model, we answer two questions related to the determinants of highly active antiretroviral treatment (HAART) coverage across 108 countries using 2006 and 2009 HAART data. The first asks how political institutions function to enable better HAART coverage outcomes; and the second asks whether countries with higher levels of state capacity tend to have higher levels of HAART coverage. We find weak statistical evidence that both democracies and authoritarian countries can achieve high levels of HAART coverage; cultural fractionalization has less of an effect on coverage than we expected; and centralized governments achieve higher treatment coverage outcomes. The effect of political institutions is muted when we control for state capacity and funding. We apply two broad measures of state capacity, namely tax revenue as a share of GDP and our own state capacity index developed using Principal Component Factor Analysis. We find evidence that high levels of state capacity are positively related to HAART coverage outcomes.