South African Aids Activism And Global Health Politics

South Africa has the world's largest number of people living with HIV. This book offers a history of AIDS activism in South Africa from its origins in gay and anti-apartheid activism to the formation and consolidation of the Treatment Action Campaign (TAC), including its central role in the global HIV treatment access movement.

The globalization of trade, investment, and finance continues apace. Many have benefited from this, but deep inequalities persist. This book argues that the interconnections established by globalization make possible a critique of its inequality. For those who take seriously human dignity, equality is a basic presumption of social institutions.

Drawing on more than one hundred interviews conducted across eighteen countries, the author documents the emergence of a diverse range of community-based, nongovernmental, and civil society groups engaged in patient-focused AIDS advocacy worldwide. She also critically evaluates the evolving role of these groups in challenging authoritative global health governance schemes put in place by what she describes as overcontrolling or sanctimonious governments, scientists, religious figures, journalists, educators, and corporations.--From publisher description.

From the historical roots of AIDS activism in the struggle for African liberation to the everyday work of community education in Khayelitsha, Sustaining Life tells the story of how the rights-based South African AIDS movement successfully transformed public health institutions, enabled access to HIV/AIDS treatment, and sustained the lives of people living with the disease. Typical accounts of the South African epidemic have focused on the political conflict surrounding it, Theodore Powers observes, but have yet to examine the process by which the national HIV/AIDS treatment program achieved near-universal access. In Sustaining Life, Powers demonstrates the ways in which non-state actors, from caregivers to activists, worked within the state to transform policy and state-based institutions in order to improve health-based outcomes. He shows how advocates in the South African AIDS movement channeled the everyday experiences of poor and working-class people living with HIV/AIDS into tangible policy changes at varying institutional levels, revealing the primacy of local action for expanding treatment access. In his analysis of the transformation of the state health system, Powers addresses three key questions: How were the activists of the movement able to overcome an AIDS-dissident faction that was backed by government power? How were state health institutions and HIV/AIDS policy transformed to increase public sector access to treatment? Finally, how should the South African campaign for treatment access inform academic debates on social movements, transnationalism, and the state? Based on extended participant observation and in-depth interviews with members of the South African AIDS movement, Sustaining Life traces how the political principles of the anti-apartheid movement were leveraged to build a broad coalition that changed national HIV/AIDS policy norms and highlights how changes in state-society relations can be produced by local activism.

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.

Successive South African governments have had controversial views on HIV and AIDS which have led to allegations that South Africa is in a state of denial about the AIDS epidemic. This book attempts to determine the validity of such claims of government denial by formulating and testing a denial hypothesis.The hypothesis is contextualized with an overview of the South African epidemic as well as a review of allegations of government denial. It reveals possible political factors that may motivate policy-makers to resort to official denial and tentatively concludes with a confirmation of the allegations contained in the denial hypothesis. However, this is done within the broader notion that denial is inherently vague and couched in language (rarely in writing) and therefore difficult to test with certainty and as such this book's real value lies in the insights gained into the complex politics of denial. By exploring the dynamics of denial and denialism and applying this to the South African AIDS epidemic, this study provides a comprehensive analysis.

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.

The author argues for the continued importance of NGOs, social movements and other 'civil society' actors in creating new forms of citizenship and democracy in South Africa. Critics of liberalism in Europe and North America argue that a stress on 'rights talk' and identity politics has led to fragmentation, individualisation and depoliticisation. But are these developments really signs of 'the end ofpolitics'? In the post-colonial, post-apartheid, neo-liberal new South Africa poor and marginalised citizens continue to struggle for land, housing and health care. They must respond to uncertainty and radical contingencies on a daily basis. This requires multiple strategies, an engaged, practised citizenship, one that links the daily struggle to well organised mobilisation around claiming rights. Robins argues for the continued importance of NGOs, socialmovements and other 'civil society' actors in creating new forms of citizenship and democracy. He goes beyond the sanitised prescriptions of 'good governance' so often touted by development agencies. Instead he argues for a complex, hybrid and ambiguous relationship between civil society and the state, where new negotiations around citizenship emerge. Steven L. Robins is Professor of Social Anthropology in the University of Stellenbosch and editorof Limits to Liberation after Apartheid (James Currey). Southern Africa (South Africa, Botswana, Namibia, Lesotho, Swaziland): University of KwaZulu-Natal Press (PB)