The Politics Of Global Aids

This book examines the global governance of the HIV/AIDS epidemic, interrogating the role of this international system and global discourse on HIV/AIDS interventions. The geographical focus is Sub-Saharan Africa since the region has been at the forefront of these interventions. There is a need to understand the relationship between the international political environment and the impact of resulting policies on HIV/AIDS in the context of people’s lives. Hakan Seckinelgin points out a certain disjuncture between this governance structures and the way people experience the disease in their everyday lives. Although the structure allows people to emerge as policy relevant target groups and beneficiaries, the articulation of needs and design of policy interventions tends to reflect international priorities rather than people’s thinking on the problem. In other words, he argues that while the international interventions highlight the importance attributed to the HIV/AIDS problem, the nature of the system does not allow interventions to be far reaching and sustainable. Offering a critical contribution to the understanding of the problems in HIV/AIDS in Sub-Saharan Africa, International Politics of HIV/AIDS will be invaluable to students and researchers of health, international politics and development.

This timely book looks critically at the policy response to AIDS and its institutionalization over time. It raises important questions about who benefits, who decides, and in whose interests decisions are made. Taking the early international response to the epidemic as its starting point, and focusing on the work of agencies such as UNAIDS, it identifies two logics underpinning strategy to date. First, the idea of HIV as a ‘global emergency’ which calls for an extraordinary response. Second, the claim that medicine offers the best way of dealing with it. The book also identified the rise of something more dominant – namely Global AIDS – or the logic and system that seeks to displace all others. Promulgated by UNAIDS and its partner agencies, Global AIDS claims to speak the truth on behalf of affected persons and communities everywhere. Founded on solidarity claims concerning the international HIV movement, and distinctive knowledge practices which determine what needs to be done. Alternative views about the nature of the epidemic or the best response are rejected as irrelevant for falling outside the master framing of the epidemic that Global AIDS provides. But to what extent is this biomedical and emergency framing of the epidemic sustainable, and to what extent does it speak to the sustainability of lives as affected people wish them to be lived? Does scientific and biomedical advance provide all the answers, or do important social and political issues need to be addressed? This book provides an innovative framework with which to think about these and other sustainability challenges for the future.

In the mid-1990s, experts predicted that India would face the world's biggest AIDS epidemic by 2000. Though a crisis at this scale never fully materialized, global public health institutions, donors, and the Indian state initiated a massive effort to prevent it. HIV prevention programs channeled billions of dollars toward those groups designated as at-risk—sex workers and men who have sex with men. At Risk captures this unique moment in which these criminalized and marginalized groups reinvented their "at-risk" categorization and became central players in the crisis response. The AIDS crisis created a contradictory, conditional, and temporary opening for sex-worker and LGBTIQ activists to renegotiate citizenship and to make demands on the state. Working across India and Kenya, Gowri Vijayakumar provides a fine-grained account of the political struggles at the heart of the Indian AIDS response. These range from everyday articulations of sexual identity in activist organizations in Bangalore to new approaches to HIV prevention in Nairobi, where prevention strategies first introduced in India are adapted and circulate, as in the global AIDS field more broadly. Vijayakumar illuminates how the politics of gender, sexuality, and nationalism shape global crisis response. In so doing, she considers the precarious potential for social change in and after a crisis.

AIDS, Sex, and Culture is a revealing examination of the impact the AIDS epidemic in Africa has had on women, based on the author's own extensive ethnographic research. based on the author's own story growing up in South Africa looks at the impact of social conservatism in the US on AIDS prevention programs discussion of the experiences of women in areas ranging from Durban in KwaZulu Natal to rural settlements in Namibia and Botswana includes a chapter written by Sibongile Mkhize at the University of KwaZulu Natal who tells the story of her own family’s struggle with AIDS

Why have governments responded to the HIV/AIDS pandemic in such different ways? During the past quarter century, international agencies and donors have disseminated vast resources and a set of best practice recommendations to policymakers around the globe. Yet the governments of developing countries in sub-Saharan Africa, Asia, Latin America, and the Caribbean continue to implement widely varying policies. Boundaries of Contagion is the first systematic, comparative analysis of the politics of HIV/AIDS. The book explores the political challenges of responding to a stigmatized condition, and identifies ethnic boundaries--the formal and informal institutions that divide societies--as a central influence on politics and policymaking. Evan Lieberman examines the ways in which risk and social competition get mapped onto well-institutionalized patterns of ethnic politics. Where strong ethnic boundaries fragment societies into groups, the politics of AIDS are more likely to involve blame and shame-avoidance tactics against segments of the population. In turn, government leaders of such countries respond far less aggressively to the epidemic. Lieberman's case studies of Brazil, South Africa, and India--three developing countries that face significant AIDS epidemics--are complemented by statistical analyses of the policy responses of Indian states and over seventy developing countries. The studies conclude that varied patterns of ethnic competition shape how governments respond to this devastating problem. The author considers the implications for governments and donors, and the increasing tendency to identify social problems in ethnic terms.

One in six adults in sub-Saharan Africa will die in their prime of AIDS. It is a stunning cataclysm, plunging life expectancy to pre-modern levels and orphaning millions of children. Yet political trauma does not grip Africa. People living with AIDS are not rioting in the streets or overthrowing governments. In fact, democratic governance is spreading. Contrary to fearful predictions, the social fabric is not being ripped apart by bands of unsocialized orphan children. AIDS and Power explains why social and political life in Africa goes on in a remarkably normal way, and how political leaders have successfully managed the AIDS epidemic so as to overcome any threats to their power. Partly because of pervasive denial, AIDS is not a political priority for electorates, and therefore not for democratic leaders either. AIDS activists have not directly challenged the political order, instead using international networks to promote a rights-based approach to tackling the epidemic. African political systems have proven resilient in the face of AIDS's stresses, and rulers have learned to co-opt international AIDS efforts to their own political ends. In contrast with these successes, African governments and international agencies have a sorry record of tackling the epidemic itself. AIDS and Power concludes without political incentives for HIV prevention, this failure will persist.

Peter Piot, founding executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), recounts his experience as a clinician, scientist, and activist fighting the disease from its earliest manifestation to today. The AIDS pandemic was not only catastrophic to the health of millions worldwide but also fractured international relations, global access to new technologies, and public health policies in nations across the globe. As he struggled to get ahead of the disease, Piot found science does little good when it operates independently of politics and economics, and politics is worthless if it rejects scientific evidence and respect for human rights. Piot describes how the epidemic altered global attitudes toward sexuality, the character of the doctor-patient relationship, the influence of civil society in international relations, and traditional partisan divides. AIDS thrust health into national and international politics where, he argues, it rightly belongs. The global reaction to AIDS over the past decade is the positive result of this partnership, showing what can be achieved when science, politics, and policy converge on the ground. Yet it remains a fragile achievement, and Piot warns against complacency and the consequences of reduced investments. He refuses to accept a world in which high levels of HIV infection are the norm. Instead, he explains how to continue to reduce the incidence of the disease to minute levels through both prevention and treatment, until a vaccine is discovered.

"With more than 40 million people living with HIV/AIDS, and more than 25 million dead from related diseases since the early 1980s, the need to understand the causes and impact of the pandemic is manifest. In response, The Global Politics of AIDS explores power and politics at multiple levels, ranging from individual behavior to corporate boardrooms to international institutions and forces." "The authors combine careful scholarship with sensitivity to both the suffering of those afflicted and the frustration of those seeking to bring about meaningful change. All royalties from sales of the book will be donated to AIDS-related charities."--BOOK JACKET.

HIV/AIDS is the major political challenge of our time. Based on empirical observations from all over the world, this book examines how HIV/AIDS has become increasingly transnational, as nation states have extended their programmes across borders, and transnational networks have increased their activities.

Brazil’s public policy response to the AIDS epidemic preceded those of many developing countries. During my tenure as President, in 1996, Brazil adopted a law guaranteeing free and universal access to AIDS treatment for all people living with HIV/AIDS. Brazil became the first developing country to provide publicly-financed AIDS treatment for all people living with HIV/AIDS. We now have one of the world’s most successful AIDS programs that is considered a model for other dev- oping countries. Today, 185,000 people receive life-saving AIDS cocktails in Brazil, and thousands of lives have been saved. But this was not an easy battle. There were many challenges along the way. Twenty years ago, Brazil’s achie- ments today might have seemed impossible. During the 1980s, in Brazil, as elsewhere, there was overwhelming stigma associated with AIDS; people living with HIV often lost their jobs and died quickly before the advent of life-saving antiretroviral drugs. Brazil’s AIDS movement was extraordinarily important in promoting progressive AIDS policies; associations of people living with HIV were the first to denounce pervasive AIDS-related discri- nation and called public attention to the importance of AIDS. Activists protested in the streets for over a decade, engaged the media, and framed AIDS as a human rights issue.