Despite the massive investment of international donors to support HIV/AIDS programs in Africa, there has been far too little investigation of the politics of the allocation of these resources. Building off more than a decade of research, Kim Yi Dionne fill this gap by demonstrating how the priorities of global health donors are oftentimes misaligned with those who benefit from these programs (citizens) and those who are often engaged implement these programs (communities). She demonstrates how misalignments of priorities have contributed to poor program outcomes and likely poor health outcomes. Notably, her book shines an important light on the little understood role of village headmen in Malawi in the fight against HIV/AIDS. The implications of her work are clear and apply to all global health programs, donors need to invest more to better understand the needs of citizens to make better use of stagnating global health aid.

–Karen Grépin
Associate Professor of Health Sciences at Wilfrid Laurier University

In this sophisticated and insightful book, Kim Yi Dionne illuminates the challenges to global intervention against AIDS in Africa. With multi-method research and rich data, Dionne convincingly shows the disconnect between the priorities of international donors and the intended beneficiaries of aid and she argues that global intervention is undermined when donor priorities are privileged over citizens’ priorities.

–Dominika Koter
Author of Beyond Ethnic Politics in Africa and Assistant Professor of Political Science at Colgate University

Drawing on extensive fieldwork in Malawi, Dionne offers a provocative warning to the international AIDS community about the dangers of pushing policies without sufficient consultation and buy-in from local people who may have other priorities. This book will be of great interest to AIDS experts and development practitioners alike.

–Joshua Busby
Co-Author of AIDS Drugs for All: Social Movements and Market Transformations and Associate Professor of Public Affairs at the LBJ School of Public Affairs, University of Texas at Austin

Dionne uses fascinating cases across a number of sub-Saharan African countries to demonstrate how the mismatch between donor and citizen priorities limits the effectiveness of HIV programming, as does the sheer number of actors involved at multiple levels of governance. One of the book’s key contributions is its attention to AIDS interventions at the subnational level, particularly the role of village headmen, which Dionne situates with rich detail in what she aptly calls the global supply chain of AIDS interventions.

–Rachel Sullivan Robinson
Author of Intimate Interventions in Global Health: Family Planning and HIV Prevention in Sub-Saharan Africa and Associate Professor, School of International Service, American University