Cooperation and Collaboration Impact on Policy Development: HIV/AIDS policy in Latvia

This article describes a case study of trends of governance approach implementation in the health policy development and implementation process in Latvia, in the state in transition, or “new democracy”. Latvia became an independent democratic state in 1991, regaining its freedom after being part of the Soviet Union for 50 years. As the three Baltic States (Latvia, Lithuania, and Estonia) had a common history and starting point in the health reform implementation, the data of Human Immunodeficiency Virus (HIV) incidence and implemented policy steps were analyzed and compared of all the three states. The research provides insight into the HIV/Acquired Immune Deficiency Syndrome (AIDS) situation in Latvia from the time when the first patient was diagnosed till nowadays, describing the initiatives that were implemented to combat the spread of HIV infection and analyze the impact of different stakeholders in the policy development and implementation process. Although the main reform implementation actors in Latvia were Non-Governmental Organizations (NGOs) or patient organizations by performing cooperation and collaboration with all the actors involved in the policy development and implementation process, more profound investigation reveals that major impact came from “old democracies”, international and global organizations as well as from physicians and commercial powers by providing a suitable environment for the reform development.