Skip to main content
Top

2017 | Book

The Politics of Global AIDS

Institutionalization of Solidarity, Exclusion of Context

insite
SEARCH

About this book

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.

Table of Contents

Frontmatter
Chapter 1. Introduction
Abstract
This chapter sets out the rationale behind the book and describes its conceptual underpinnings. It focuses in particular on the idea of politics, which grounds my approach to understanding both the nature of Global AIDS and its implications. Jacques Rancière’s work provides the conceptual framework for the chapter. This highlights the importance of considering the politics of ‘Global AIDS’ rather than the global politics of AIDS at a time when the sustainability of the lives of people living with HIV is becoming a major concern for the future concern. Using such an approach, the chapter analyses the practices associated with Global AIDS in a number of policy areas. Following this, the methodological grounds that make possible an analysis of the politics of Global AIDS – developed through an engagement with Niklas Luhman’s systems theory – are outlined.
Hakan Seckinelgin
Chapter 2. Pathways to the Politics of Global AIDS and the Meanings of AIDS
Abstract
In this chapter, I look more closely at the emergence of the politics of Global AIDS by documenting the social and political challenges that were responded to by different actors. Central here is the claim that the way in which HIV is understood depends on the circumstances. Contextual factors create particular meanings of the disease, which evolve as circumstances change. I argue that a similar process also applies to the way in which the politics of AIDS developed throughout the 1980s and 1990s in the period prior to the creation of UNAIDS. In a similar way to how people with HIV have made sense of a new disease, so too did organizations, both nationally and internationally, as they encountered and engaged with the emergence of a new condition within specific socio-political circumstances.
Hakan Seckinelgin
Chapter 3. The Institutionalization of Global AIDS and the Creation of the Joint United Nations Programme on HIV/AIDS (UNAIDS)
Abstract
This chapter focuses on the creation of the Joint United Nations Programme on HIV/AIDS (UNAIDS), and how this new formation set about institutionalizing a global AIDS perspective. The chapter considers the main motivations behind this creation, which included the need to create a coherent and shared understanding of HIV, together with a coordinated policy framework to bring together different technical and political capacities for coherent policy intervention in multiple country contexts. The chapter argues that this process of creating a shared understanding of expected outcomes led to a shared understanding of the disease laying the foundations for the politics of Global AIDS.
Hakan Seckinelgin
Chapter 4. Civil Society and Solidarity in the Politics of Global AIDS
Abstract
This chapter focuses on two key transitions: first, the transformation of community activism around HIV to a more professionalized form of activity lobbying for political authority; the second, from a local to a more international activist stance. This focus on transitions considers how such changes informed how civil society came to be understood in relation to HIV, and how this understanding in turn influenced the way in which civil society in developing countries is now framed by international actors including international NGOs. Such an analysis allow me to consider how far the ethos of solidarity, often discussed in the literature as broadly based on the AIDS activism of the 1980s, relates to the circumstances in which many groups currently work in resource-poor settings.
Hakan Seckinelgin
Chapter 5. Global AIDS and the Politics of Knowledge
Abstract
This chapter focuses on the question of how the policy priorities of Global AIDS have informed the nature of knowledge developed in this field. It argues that while knowledge of HIV has developed rapidly since the 1980s, and which this expansion has been important, it conceals a central weakness. This weakness stems from the way in which specifically bio-medical forms of understanding has been deployed within the Global AIDS framework. This chapter offers a critical analysis of knowledge production processes and their implications for policy thinking. The focus is also on the way in which Global AIDS system disseminates and diffuses knowledge through the mechanism of international conferences.
Hakan Seckinelgin
Chapter 6. Evidence-Based Policy: Randomised Controlled Trials’ Knowledge Claims to AIDS Policy
Abstract
This chapter considers the way in which the Randomised Controlled Trial (RCT) as a policy-relevant knowledge production practice has influenced Global AIDS policy thinking. It unpacks the issue by looking both at the logic of RCT design and challenges to implementing RCT-based polices outside of the trial context. It is argued that RCT method has been strongly endorsed by the Global AIDS system because of its close links to a biomedical perspective. What remains to be answered, however, is why RCTs have been so extensively used to ground Global AIDS policy decisions given widespread critical analysis of RCT method and its limits to generalisability.
Hakan Seckinelgin
Chapter 7. Context Matters! But Why?
Abstract
Most RCT-related knowledge claims explicitly stress the importance of adherence. Although context may additionally be mentioned in addition to adherence, I argue that all adherence is a function of context. In the light of this, this chapter considers what is meant by ‘context’ within discussions of Global AIDS and compares this with some discussions of context within the social sciences more generally. After considering briefly arguments about Voluntary Medical Male Circumcision as an HIV-related intervention, I focus on the structural drivers’ debate as one attempt to pay serious attention to notions of context as part of the global AIDS response. I conclude that knowledge needs and claims within Global AIDS system systematically misunderstands the idea of context. This, I argue, diverts attention away from individual and collective experience of HIV and AIDS as part of everyday life.
Hakan Seckinelgin
Chapter 8. Conclusion: Emergency, Sustainability and Success
Abstract
This book began by considering how the international system understands and engages with the needs of those who are addressed by its policies. To do this it analysed the emergence of the politics of Global AIDS and the institutionalization of its political and policy practices over time. Two key questions motivating the analysis were: how best to think about the politics of the global AIDS response today, and what are the implications of this for a future that should more broadly be about the politics of sustainability of lives? These questions were motivated by the shifting focus from the emergency logic that first defined the politics of the global AIDS response towards a longer-term approach.
Hakan Seckinelgin
Backmatter
Metadata
Title
The Politics of Global AIDS
Author
Hakan Seckinelgin
Copyright Year
2017
Electronic ISBN
978-3-319-46013-0
Print ISBN
978-3-319-46011-6
DOI
https://doi.org/10.1007/978-3-319-46013-0