Resetting the agenda: the makings of 'A New Era' of HIV policy in NSW

The New South Wales Government's NSW HIV Strategy 2012-2015: A New Era represented a punctuated shift of policy direction, and was remarkable for its ground-breaking declaration that HIV transmission could be virtually ended by 2020. This significant policy shift occurred after a long period of stability and only incremental change, some of it represented by policy decline as political and public interest in HIV waned. This article uses punctuated equilibrium theory to explore the conditions that allowed for change, and the roles played by new and long-standing actors in the HIV policy subsystem. It explains the importance of challenges to the policy image and the policy venue as key mechanisms that allowed new possibilities, created by advances in the scientific understanding of HIV, to be incorporated rapidly into government policy.