THE POLITICS OF PUBLIC HEALTH EMERGENCIES: AIDS EPIDEMICS IN INDIA AND SOUTH AFRICA
This dissertation examines the policies related to the AIDS epidemics in India and South Africa, with a special focus on the politics of knowledge. Drawing on research in social studies of science, the study asks how national governments conceptualized AIDS-related policies, and how these policies were shaped by international technical institutions and non-governmental organizations. The study revealed that international technical institutions such as the World Bank and the World Health Organization often provided prior templates for how governments should manage AIDS epidemics. These templates included established technologies for epidemiological modeling, set categories for conceptualizing risk, and generic models for public health interventions. On a different register, non-governmental organizations used a rights-based discourse to establish novel conceptions of expertise and citizenship. The research showed that the South African and Indian governments responded differently to international expertise and activism. India availed of many frameworks and funds brought in by international experts. This embrace of global knowledge sat alongside a silencing of local experiences and history, as the vast lessons from India?s own public health past were neglected in designing national AIDS policies. South Africa, in contrast, was skeptical of international expertise; it ortrayed the global epidemic management machinery as a vehicle for expressing and legitimating old racial stereotypes. To justify its controversial policies and skepticism of mainstream AIDS-related science, the South African government pointed to a history of racism in medicine. This dissertation's comparative analysis of AIDS-related policymaking in two crucial democratic countries illuminates the broader shifts taking place in the conceptualization of public health in the global south. Public health policy, which used to be primarily in the domain of the national government, is increasingly in the purview of international technical organizations and non-governmental groups. No more is public health solely associated with large-scale prevention and primary health care for the larger collective. Instead, the emerging conceptions of public health focus on individual-oriented, rights-based, access to treatment. These changing conceptions of public health reflect new logics of democratic politics and globalization.