United against HIV/AIDS? Politics of Local Governance in Lusikisiki, South Africa
Professor i samfunnsgeografi, Kristian Stokke, har sammen med tidligere masterstudent, Jane Vogt Evensen, skrevet en artikkel om politiske utfordringer ved å gjennomføre et behandlingsprogram for HIV/AIDS i Sør-Afrika. Artikkelen ble nylig publisert i Journal of Southern African Studies.
United Against HIV/AIDS? Politics Of Local Governance In HIV/AIDS Treatment In Lusikisiki, South Africa
Authors: Jane Vogt Evensen ;Kristian Stokke
Published in: Journal of Southern African Studies, Volume 36, Issue 1 March 2010 , pages 151 - 167
South Africa is currently moving from a polarised politicisation of the right to treatment, towards contentions over the implementation of treatment programmes for people living with HIV/AIDS. This article examines the politics of local governance in the Lusikisiki HIV/AIDS programme in the Eastern Cape Province. This is a case where the principal state and civil society actors, the Department of Health (DoH) and the Treatment Action Campaign (TAC), seem to have transcended previous conflicts and entered into partnership facilitated by the international NGO Mdecins Sans Frontires (MSF). This article examines the political dynamics associated with the initiation of the Lusikisiki programme, the mobilisation of local communities, and the transition from pilot project to public sector programme for HIV/AIDS treatment. We observe that the programme has been characterised by both co-operation and conflict between the DoH, the TAC and MSF, and that local politics in the Lusikisiki programme are inscribed in a broader multi-scale politics of defining and implementing policies for HIV/AIDS treatment in South Africa. This complex and contentious politics of treatment have produced numerous hurdles for initiating, operating and mainstreaming participatory local governance for HIV/AIDS treatment in Lusikisiki. The sustainability of the Lusikisiki programme seems to depend upon national level policies and directives, especially regarding task shifting and adherence counsellors. Bottlenecks emanating from the national level of government demonstrate the multi-scale character of local governance of HIV/AIDS treatment. Although the politics of local governance is highly contextual, the importance of non-local political dynamics implies that the Lusikisiki programme also provides general lessons for future HIV/AIDS treatment programmes in other localities in South Africa.