The development of a national HIV Plan in Belgium: Achieving consensus despite institutional complexity

- Belgium formulated a national HIV Plan based on UN and WHO recommendations.
- The development demonstrated strengths and limitations of a consensus strategy.
- The window of opportunity allowed for agreement on procedures and actions.
- A strategic plan without an operating structure was presented to the public in 2013.
- The protocol agreement did not commit to budgets, priorities, and target figures.

BackgroundThe development of a national HIV Plan poses serious challenges to countries with a complex distribution of legal powers such as Belgium. This article explores how the Belgian national HIV Plan 2014-2019 was developed.MethodsApplying the policy streams model of John Kingdon, the analysis of the HIV Plan development process was based on published government statements, parliamentary documents, and websites of stakeholders.ResultsThe Federal Ministry of Health initiative to achieve the HIV Plan was characterized by a coordinating role with a participatory approach towards the other Belgian governments and stakeholders. The 2013 protocol agreement of the Belgian governments committed them to principles, actions, and cooperation, but not to budgets, priorities, or target figures.DiscussionThe Federal government followed a successful strategy to create momentum and commitment to a common national vision on HIV/AIDS. The window of opportunity was not sufficient to create an implementation plan prior to the 2014 elections, and major challenges were left to the subsequent governments, including financing.ConclusionThe country of Belgium represents an example of a consensus strategy to achieve a national HIV Plan with its achievements and limits within institutional complexity and limited Federal legal powers.