The Political Management Of Hiv And Aids In South Africa

This book analyzes successive governments' management of the AIDS epidemic in South Africa. The book covers the years 1982-2005, using expert thinking regarding public policy making to identify gaps in the public sector's handling of the epidemic. It highlights critical lessons for policy makers and other public health managers.

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.

The political impact of HIV/AIDS varies greatly and is difficult to map. States depend on how governments choose to manage the political implications of HIV and AIDS, both those stemming from the erosions of its own capacity as well as those that originate from their changing relationship on a national and international level. Across the developing world, HIV/AIDS is slowly killing adults in their most productive years, hollowing out state structures, deepening poverty and raising profound questions that touch on the organization of all aspects of social, economic and political life. With the epidemic showing scant signs of slowing down, this innovative volume assesses how HIV/AIDS affects governance and, conversely, how governance affects the course of the epidemic. In particular, the volume:

Sub-Saharan Africa is a region devastated by HIV/AIDS. The extent of the epidemic is only now becoming clear, as increasing numbers of people with HIV are becoming ill. In the absence of massively expanded prevention, treatment and care efforts, the AIDS death toll on the continent is set to escalate rapidly. Despite progress being achieved in localized settings, the alarming statistics reflect the continuing failure of advanced countries to mount a response that matches the scale and severity of the African HIV/AIDS crisis. Over and above the colossal personal suffering, the dire social and economic consequences for fragile nation-states are already being felt, not only in health but in education, industry, agriculture, transport, human resources and economies in general. Countries already crippled by drought, poverty, debt, forced migration and civil war must now contend with massive deterioration in child survival rates and life expectancy, the erosion of the economic family base, massive and insupportable demands on health and public services, chronic labour shortages and volatile national security. Through a critical and detailed exploration of specific case studies, this invaluable volume brings together an unparalleled array of international contributors to redefine the political and economic contours of this calamitous epidemic. It examines the impact of the shortfalls in the 'Global Fund' allocation, the slow pace of administrative processing of aid and the weaknesses of institutional responses to the crisis from African countries and their partners in the global health community. It is essential reading for all concerned with public health, epidemiology, HIV/AIDS research, globalization, development, Africa and indeed our shared future. Features include: ” Unique assessments of HIV/AIDS and its impact on democracy and governance in African states ” Wide-ranging regional and country studies by the foremost thinkers in their fields ” Multi-disciplinary contributions from areas including: Politics, Sociology, Public Health and Development Studies ” Compelling and convincing evidence, thematic in approach ” Innovative and culturally specific insights for long-term planning, care and support

Through an in-depth examination of the interactions between the South African government and the international AIDS control regime, Jeremy Youde examines not only the emergence of an epistemic community but also the development of a counter-epistemic community offering fundamentally different understandings of AIDS and radically different policy prescriptions. In addition, individuals have become influential in the crafting of the South African government's AIDS policies, despite universal condemnation from the international scientific community. This study highlights the relevance and importance of Africa to international affairs. The actions of African states call into question many of our basic assumptions and challenge us to refine our analytical framework. It is ideally suited to scholars interested in African studies, international organizations, global governance and infectious diseases.

In this book, France's leading medical anthropologist takes on one of the most tragic stories of the global AIDS crisis—the failure of the ANC government to stem the tide of the AIDS epidemic in South Africa. Didier Fassin traces the deep roots of the AIDS crisis to apartheid and, before that, to the colonial period. One person in ten is infected with HIV in South Africa, and President Thabo Mbeki has initiated a global controversy by funding questionable medical research, casting doubt on the benefits of preventing mother-to-child transmission, and embracing dissidents who challenge the viral theory of AIDS. Fassin contextualizes Mbeki's position by sensitively exploring issues of race and genocide that surround this controversy. Basing his discussion on vivid ethnographical data collected in the townships of Johannesburg, he passionately demonstrates that the unprecedented epidemiological crisis in South Africa is a demographic catastrophe as well as a human tragedy, one that cannot be understood without reference to the social history of the country, in particular to institutionalized racial inequality as the fundamental principle of government during the past century.

For three decades post-apartheid, the HIV/AIDS epidemic from first acknowledgement to its management as a chronic disease, demanded unparalleled attention. This was nowhere more evident than in South Africa. This book explores how the state responded to its responsibilities to defend and protect (human) security. Linking this to the role of the state as sovereign protector and provider of security, it applies the findings to the broader re-interpretation of sovereign responsibility in the 21st Century. This book does not seek to absolve the South African state of its responsibility to respond. Moreover, it argues that although the state, the government, before, during, and after the transition to democracy, was aware of and acknowledged the threat - political, economic and social - posed by the epidemic, it nonetheless chose not to make the epidemic a priority policy issue. As a result, it argues that the South African HIV/AIDS case illustrates the tension inherent between a state’s ultimate sovereign responsibility to respond and its tactical dependence on external contributors to meet the demands of all of its constituents.

AIDS has a unique political history. As fears grew of a global pandemic on the scale of AIDS in sub-Saharan Africa, AIDS was briefly treated as an issue of high politics in the international arena and generated significant resources for country programmes. That initial commitment is now declining, and if AIDS is to maintain its visibility and contribution to global solidarity, human rights and dignity, its politics will have to evolve to reflect the profound geo-political, economic and social transformations underway today. This volume brings together leading scholars from a variety of disciplines who work at the intersection of politics and HIV. They reflect on the lessons learned from the past thirty years of the politics of AIDS and how political science, writ large, can further contribute to the understanding and practice of political mobilization around AIDS. Through case studies and analysis, new insights into identity politics and social movements in countries as diverse as Brazil, Switzerland, Vietnam and Zambia are offered alongside new approaches to understanding the determinants and incentives which generate political will and commitment. This book was published as a special issue of Contemporary Politics.