Boundaries of Contagion

Boundaries of Contagion: How Ethnic Politics Have Shaped Government Responses to AIDS

Evan S. Lieberman
Copyright Date: 2009
Pages: 368
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  • Book Info
    Boundaries of Contagion
    Book Description:

    Why have governments responded to the HIV/AIDS pandemic in such different ways? During the past quarter century, international agencies and donors have disseminated vast resources and a set of best practice recommendations to policymakers around the globe. Yet the governments of developing countries in sub-Saharan Africa, Asia, Latin America, and the Caribbean continue to implement widely varying policies.Boundaries of Contagionis the first systematic, comparative analysis of the politics of HIV/AIDS. The book explores the political challenges of responding to a stigmatized condition, and identifies ethnic boundaries--the formal and informal institutions that divide societies--as a central influence on politics and policymaking.

    Evan Lieberman examines the ways in which risk and social competition get mapped onto well-institutionalized patterns of ethnic politics. Where strong ethnic boundaries fragment societies into groups, the politics of AIDS are more likely to involve blame and shame-avoidance tactics against segments of the population. In turn, government leaders of such countries respond far less aggressively to the epidemic. Lieberman's case studies of Brazil, South Africa, and India--three developing countries that face significant AIDS epidemics--are complemented by statistical analyses of the policy responses of Indian states and over seventy developing countries. The studies conclude that varied patterns of ethnic competition shape how governments respond to this devastating problem. The author considers the implications for governments and donors, and the increasing tendency to identify social problems in ethnic terms.

    eISBN: 978-1-4008-3045-9
    Subjects: Political Science

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
    (pp. ix-x)
    (pp. xi-xii)
    (pp. xiii-xxii)
  6. 1 Introduction
    (pp. 1-24)

    “AIDS knows no boundaries.”For much of the history of the AIDS epidemic, activists and officials around the world have repeated this incantation. As one diplomat described AIDS, “It discriminates against no ethnicity, no gender, no age, no race, no religion. It is a global problem that threatens us all.”¹ From a strictly biomedical standpoint the claim is accurate. In 2006, UNAIDS, the lead international organization for AIDS control, estimated that approximately 65 million people—men and women, young and old, rich and poor, black and white, Christian and Muslim, from every continent and virtually every country—had been infected...

  7. 2 A Theory of Boundary Politics and Alternative Explanations
    (pp. 25-60)

    In this chapter, I develop a general theory of how boundary institutions influence the politics of public policymaking. I draw upon social scientific theories of social identity and risk in order to enrich our understanding of the potentially negative effects of ethnic heterogeneity on the provision of public goods¹ and development. Using this theory, I detail more specific propositions about the relationship between ethnic boundaries and the development of national AIDS policies, which are explored through comparative and historical analyses in chapters 4–6. I also highlight alternative explanations of policymaking, and of AIDS policy more specifically, as the basis...

  8. 3 Globalization and Global Governance of AIDS: The Geneva Consensus
    (pp. 61-109)

    The challenge of this book is to explain similarities and differences in national responses to a common problem, AIDS. As outlined in the previous chapter, my analysis focuses on domestic variables. But national governments are embedded in an international political economy, and particularly in low- and middle-income countries, the policymaking process takes place in the context of external pressures on governments. In the area of AIDS policy, we have witnessed extensive, steadfast, and concurrent international pressures on domestic policymaking. I label the bestpractice recommendations in AIDS policy theGeneva Consensusbecause of the role of the UN agencies in framing...

  9. 4 Race Boundaries and AIDS Policy in Brazil and South Africa
    (pp. 110-172)

    This chapter takes up the challenge of explaining divergent governmental responses to AIDS in Brazil and South Africa between 1982 and 2006.¹ If we expect similar responses from countries with similar social, political, and economic profiles, we would expect parallel courses of action from these two governments (see table 4.1). When they faced AIDS epidemics, both were in the process of democratic transition, upper-middle-income countries² with high levels of economic inequality. Their public health systems were, though uneven, relatively strong in comparison to the rest of the developing world, with a cadre of informed technocrats well aware of the looming...

  10. 5 A Model-Testing Case Study of Strong Ethnic Boundaries and AIDS Policy in India
    (pp. 173-238)

    In this chapter, I explore the link between boundary politics and AIDS policymaking through a case study of India. While the previous chapter was largely a model-building analysis in the sense that much of the general argument was developed through an inductive, theory-driven, comparative analysis of Brazil and South Africa, this chapter presents a modeltesting analysis. I selected a case that was broadly comparable with the other two, ethnically divided, and with a reputation for a weak response to AIDS. Beyond confirming these characterizations with in-depth research, the main point of the analysis is to investigate whether a plausible account...

  11. 6 Ethnic Boundaries and AIDS Policies around the World
    (pp. 239-291)

    In the two previous chapters, I described the impact of ethnic boundaries on the politics of AIDS policymaking in three key countries. I found that strong caste and ethno-regional lines in India, and strong racial lines in South Africa, were sources of conflict, and ultimately of national government passivity on AIDS policy. By contrast, in Brazil, much greater ethnic tolerance and norms of mixing in combination with a legacy of institutional prohibitions against ethnic classification meant that race and ethnicity played almost no role in the politicization of HIV/AIDS for most of the history of the epidemic. It was possible...

  12. 7 Conclusion: Ethnic Boundaries or Cosmopolitanism?
    (pp. 292-306)

    Analyses of data and evidence concerning the history of AIDS and AIDS policy in the developing countries reveal that where strong ethnic boundaries were in place, governments were far less aggressive in their responses to the epidemic. While unprecedented external pressures have weighed on governments throughout the world, especially on high-prevalence countries in Africa, Asia, Latin America and the Caribbean, the adoption of the “Geneva Consensus” was strongly conditioned by the quality of ethnic politics in those countries. Substantial evidence shows that citizens and elites behaved in ways predicted by social identity theory: they attempted to disassociate themselves from a...

    (pp. 307-330)
  14. INDEX
    (pp. 331-345)