Project delivery in HIV/AIDS and TB in Southern Africa: the cross-cultural management imperative.

This paper reports the findings of a broad based study that initially investigated a possible gap in global inputs into the fight against HIV/AIDS and TB co-infection, and outputs in terms of results achieved. We propose that such a gap may be hypothesized to be due, at least in part, to inappropriate management regimes within the global health governance structure. We do not simply question the effectiveness of the management of programs and projects, but rather the inappropriateness resulting from the lack of addressing cross-cultural issues. The factors facilitating or hampering project service delivery are examined by looking at twelve case studies in Botswana and South Africa. These data are complemented with seven semi-structured interviews with donor organizations and NGOs conducted in the North. Cultural interactions are investigated by using the concept of ‘interfaces’. Results suggest that there is a disjuncture between the global and local level that affects project delivery. The main issues hampering project outcomes can be summarized as systemic, structural and cultural. The article’s main contributions are both theoretical, looking at global project delivery from a cross-cultural management perspective, as well as to development praxis by highlighting the need to focus more critically on cross-cultural management issues within the global health governance structure, and indeed within international development as a whole.

Post refereed version as permitted by publisher.