Sustaining Life
PENNSYLVANIA STUDIES IN HUMAN RIGHTS
Bert B. Lockwood, Series Editor
A complete list of books in the series
is available from the publisher.
Sustaining Life
AIDS Activism in South Africa
Theodore Powers
UNIVERSITY OF PENNSYLVANIA PRESS
PHILADELPHIA
Copyright © 2020 University of Pennsylvania Press
All rights reserved. Except for brief quotations used for purposes of review or scholarly citation, none of this book may be reproduced in any form by any means without written permission from the publisher.
Published by
University of Pennsylvania Press
Philadelphia, Pennsylvania 19104-4112
Printed in the United States of America on acid-free paper
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A Cataloging-in-Publication record is available from the Library of Congress
ISBN 978-0-8122-5200-2
For Kat, Emma, and Leo
CONTENTS
Introduction. People, Pathogens, and Power: Situating the South African HIV/AIDS Epidemic
Chapter 2. The Political History of South African HIV/AIDS Activism
Chapter 3. Occupying the State: HIV/AIDS Activism and the South African National AIDS Council
Chapter 5. Community Health Activism, AIDS Dissidence, and Local HIV/AIDS Politics in Khayelitsha
Chapter 6. People Are the State: Activism, Access, and Transformation
Afterword. After Treatment Access: An Epidemic Unresolved
PREFACE
Anthropology, it is often said, attempts to bridge social and cultural difference in order to make ideas and practices from the Global South seem more familiar to those living in the Global North. In this characterization, anthropologists are seen to act as mediators who engage with “the other” in order to make their lives more comprehensible to northern publics. In doing so, anthropologists are imagined as bringing a set of academic practices to bear relative to the question of cultural variation by brandishing an expertise of a particular sort. Inherent in this formulation is a hierarchy regarding academic knowledge and an understanding of the broader context within which ideas and practices are situated, purportedly the purview of the anthropologist.
The situation that I encountered as I began research on the politics of the South African HIV/AIDS epidemic did not cohere with the generalized understanding of anthropological fieldwork described above. If anything, the hierarchy of expertise relative to the HIV/AIDS epidemic was reversed, as some research participants had contributed to publications in esteemed academic journals such as the Lancet. But, as I was to learn, the inverse relationship between researcher and expertise was not isolated to debates on epidemiology; it extended far beyond to the social dynamics that drove HIV infection, the politics that limited the public sector HIV/AIDS response, and the material privations that community-based HIV/AIDS activists navigated as part of their everyday lives.
Indeed, while my name may appear on the cover of this book, it is the knowledge and experiences of those who opened their lives to me that has provided the basis for the ethnography that follows. I was, and remain, a student of South African society, and those whose lives are outlined in this book are, and continue to be, my teachers. This book would not have been possible without their generosity, patience, and understanding as I learned about the everyday challenges of HIV/AIDS and the political struggle required to expand HIV/AIDS treatment access in South Africa. However, the contributions of my research participants were not limited to the gathering of data. They were also central to the research design that I employed in my work. As I describe in detail in Chapter 1, I followed the life pathways of research participants in order to locate field sites where politics, policy, and HIV/AIDS treatment access were negotiated. Thus, rather than a predetermined conception of the field and research sites, my project grew out of the lived experiences of those navigating the landscape of HIV/AIDS politics in South Africa.
Following people involved with the campaign for HIV/AIDS treatment access shed light onto how transnational forces articulate with HIV/AIDS politics, how debates on AIDS dissidence manifested in the townships of the Cape Flats, and how HIV/AIDS activists occupied the state to transform treatment access. This project—and the insights that it offers relative to academic debates on transnationalism, social movements, and the state—largely belongs to those who fought for HIV/AIDS treatment access in South Africa. I offer my deep thanks for their contributions, and I hope that I have done justice to their life histories and political campaigns in the pages that follow.
The process of developing and finalizing this manuscript has led me to understand that writing a book is a social act that involves the direct support of a wide network of advisors, mentors, colleagues, and family members. I first encountered the core theoretical questions that this book engages with during my undergraduate studies at Bates College. There, under the guidance of Kiran Asher and Peter VonDoepp, I undertook a senior thesis that engaged with debates on globalization, the transnational movement of cultural practices, and political economy. Both Kiran and Peter have continued to offer their mentorship and support, and I offer my thanks to them.
I am deeply indebted to faculty members in the Department of Anthropology at the CUNY Graduate Center for the rigorous training and professional guidance that I received over the course of my graduate studies. Particular thanks are in order to the members of my doctoral