An Institutional Account of China's HIV/AIDS Policy Process from 1985 to 2010

Abstract

China's HIV/AIDS policy progress displays a long-term stagnancy followed by a sudden revolution. This article utilizes multiple theoretical tools to interpret this policy progress. It identifies four phases of China's HIV/AIDS policy process: (1) institutional endurance interpreted by path dependence from historical institutionalism; (2) deinstitutionalization explained by Oliver's antecedents of deinstitutionalization; (3) the radical shift interpreted by Kingdon's agenda-setting theory; and (4) reinstitutionalization and diffusion of institutional theory. This study demonstrates the utility of “creative borrowing”—employing multiple theoretical tools to harness the strengths of each. Doing so reveals that a country's past experience with similar policy issues, the perceived political and moral legitimacy of existing policies, and a country's existing political interests can exert resistance to change. In the presence of multiple pressures for change, policy entrepreneurs who can identify policy windows and couple multiple streams may achieve radical policy shifts.