Depoliticising an epidemic - International AIDS control and the politics of health in Tanzania

Abstract : AIDS-control strategies in sub-Saharan Africa involve crucial national political compromises. Yet, they are frequently formulated in heteronomous settings dominated by Western donor agencies. Drawing on a case study of Tanzania, a country whose response to the epidemic is 97% donor-funded, this thesis develops a political economy of international AIDS control. It explores some of the specifically political aspects of the struggle against HIV/AIDS in Tanzania by analysing the formulation of national HIV-prevention and -treatment policies, and confronting these policies with a critical review of their biological and epidemiological foundations. The fieldwork combines a series of 92 in-depth interviews with key policymakers at the national level with the observation of AIDS-related decision processes in donor-government meetings. In this way, this thesis analyses the unequal political attention given to different causal stories of the spread of the virus, and their impact on the use of evidence in the formulation of HIV-prevention policies. Moreover, it describes how AIDS policymakers adopt non-decision strategies when faced with the intricate trade-offs imposed by the inescapable prioritization of HIV-prevention and -treatment interventions in a context of insufficient resources. Finally, developing upon an analysis of the controversy among players about the effects of international AIDS control on the overall coherence of national health policies, the thesis explores the contradictions of a vertical AIDS response in a context of dysfunctional health systems and poor general population health. On this basis, it examines the possibilities to elaborate an emancipatory critique.
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Submitted on : Tuesday, August 12, 2014 - 4:32:55 PM
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Moritz Hunsmann. Depoliticising an epidemic - International AIDS control and the politics of health in Tanzania. Political science. Ecole des Hautes Etudes en Sciences Sociales (EHESS); Albert-Ludwigs-Universität DEeiburg, 2013. English. ⟨tel-01055458⟩

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